Sensitivity analysis indicates that from both perspectives the service is very cost effective and may be cost saving .
CONCLUSIONS These results make alcohol screening and counseling one of the highest-ranking preventive services among the 25 effective services evaluated using st and ardized methods .
BACKGROUND The U.S. Preventive Services Task Force ( USPSTF ) has recommended screening and behavioral counseling interventions in primary care to reduce alcohol misuse .
This study was design ed to develop a st and ardized rating for the clinical ly preventable burden and cost effectiveness of complying with that recommendation that would allow comparisons across many recommended services .
Community-based alcohol counselling: a randomized clinical trial.
AIMS To examine the effectiveness of a brief intervention ( BI ) and cognitive behaviour therapy ( CBT ) for alcohol abuse . DESIGN A r and omized trial with clients r and omized within counsellors . SETTING Community-based drug and alcohol counselling in Australia . PARTICIPANTS Of all new clients attending counselling . 869 ( 82 % ) completed a computerized assessment at their first consultation . Four hundred and twenty-one ( 48 % ) were defined as eligible , of whom 295 ( 70 % ) consented and were allocated r and omly to an intervention . Of these , 13 3 ( 45 % ) were followed-up at 6 months post-test . INTERVENTIONS BI comprised the elements identified by the acronym FRAMES : feedback , responsibility , advice , menu , empathy , self-efficacy . Face-to-face counselling time was not to exceed 90 minutes . CBT comprised six consecutive weekly sessions : introduction : cravings and urges ; managing crises ; saying ' no ' and solving problems : emergencies and lapses : and maintenance . Total face-to-face counselling time was 270 minutes ( six 45-minute sessions ) . MEASUREMENTS Treatment outcomes are measured in terms of counsellor compliance , client satisfaction , weekly and binge consumption , alcohol-related problems , the AUDIT question naire and cost-effectiveness . FINDINGS When analysed on an intention-to-treat basis and for those followed-up . treatment outcomes between BI and CBT were not statistically significantly different at pre- or post-test , whether considered as continuous or categorical variables . BI was statistically significantly more cost-effective than CBT and there was no difference between them in clients ' reported levels of satisfaction . CONCLUSION For low-dependence alcohol abuse in community setting s , BI may be the treatment of choice
Sensitivity analysis indicates that from both perspectives the service is very cost effective and may be cost saving .
CONCLUSIONS These results make alcohol screening and counseling one of the highest-ranking preventive services among the 25 effective services evaluated using st and ardized methods .
BACKGROUND The U.S. Preventive Services Task Force ( USPSTF ) has recommended screening and behavioral counseling interventions in primary care to reduce alcohol misuse .
This study was design ed to develop a st and ardized rating for the clinical ly preventable burden and cost effectiveness of complying with that recommendation that would allow comparisons across many recommended services .