SIPS alcohol screening and brief interventions findings released

Findings from the SIPS trial, the largest UK alcohol screening and brief intervention study, have been released.

The study took place across key settings of Primary Care, Emergency Departments and Probation and tested the effectiveness of a range of brief intervention approaches and screening tools. A conference event took place on the 5th of March 2012 to launch the findings, with presentations available to download.

Download the 3 key SIPS factsheets:

• Alcohol Screening and Brief Intervention in Emergency Departments
• Alcohol Screening and Brief Intervention in Primary Health Care
• Alcohol Screening and Brief Intervention in Probation

SIPS covered 9 Emergency Departments, 29 GP surgeries and 20 Probation Offices across London, the South East and the North East of England. During the 13-month data collection period 10,530 patients were screened with 2,481 recruited into the study. The trial tested three key 'brief intervention' approaches of:

1. Feedback [of screening result] + Patient Information Leaflet (PIL)
2. Feedback + five minutes of structured advice using the SIPS brief advice tool + PIL
3. Feedback + 20 minutes of 'Brief Lifestyle Counselling' (BLC) + PIL

For Emergency Departments, the Modified Single Alcohol Screening Question (M-SASQ) was found to be the most efficient and effective screening tool. However successful implementation in EDs required champions and dedicated staff. In terms of results, all three approaches showed positive outcomes on drinking behaviours, with greater effects at 12 than 6 months. However when compared to simple feedback and leaflet, brief structured advice or longer 20 minute lifestyle counselling did not offer any significant advantage in terms of drinking behaviour or alcohol use disorder outcomes. However lifestyle counselling was considered to have a greater cost impact due to greater QALY gains and a greater reduction in societal costs.

In Primary Care settings, the FAST alcohol screening tool was the most efficient and effective screening tool. Successful implementation though required financial incentives, training and ongoing specialist support, though longer lifestyle/extended interventions were harder to implement. All brief intervention approaches resulted in reductions in alcohol use, but when compared to simple feedback and leaflet, brief structured advice or longer 20 minute lifestyle counselling did not offer any significant advantage in terms of drinking behaviour or alcohol use disorder outcomes. Feedback and leaflet was found to be the most cost-effective approach.

In Probation (Criminal Justice) settings, the FAST was also found to be the most effective screening tool. Successful implementation was challenging, requiring managerial support and ongoing specialist input to maintain activity. For 'increasing risk' [hazardous drinkers] who scored between 8-15 on the AUDIT, simple feedback and leaflet was as effective as longer interventions or lifestyle counselling. However for 'higher risk' [harmful] drinkers scoring 16 or more on the AUDIT, more intensive interventions were beneficial.

For tools and resources to support the delivery of alcohol brief interventions see here on the Alcohol Learning Centre. See the SIPS website for forthcoming further analysis and details of the SIPS 'junior' trial which will explore the impact of brief intervention approaches on young people.