Changes in drinking behavior among control group participants in early intervention studies targeting unhealthy alcohol use recruited in general hospitals and general practices

Background: This study aims to analyze the influence of setting variables on drinking behavior in patients with unhealthy alcohol consumption recruited proactively in general medical practices (GP) and internal and surgical wards of two general hospitals (GH) assigned to control groups. Method: This analysis compared two control groups of RCTs targeting unhealthy alcohol consumption: one outpatient sample (GP; n= 99) with one inpatient sample (GH; n= 173). Both groups were recruited via systematic screening of all patients aged between 18 and 64 years and were included in the studies if drank above the at-risk criteria of the British Medical Association (20/30. g alcohol/daily) and/or fulfilled criteria of alcohol abuse or - dependence according to DSM-IV. Both samples received a non-alcohol specific brochure on healthy living after study inclusion and were re-assessed 12 months later. Results: GH patients were significantly older, included of more males, had received less schooling and had a higher readiness to change at baseline than GP patients. Groups did not differ concerning alcohol-related diagnoses or smoking status. At the 12-month follow-up, significantly more GH patients revealed abstinence or drinking below the inclusion criteria (50.0% vs. 26.1%, p< .001). In a multivariate analysis, medical setting (GH vs. GP) remained a significant predictor for non-problematic drinking or abstinence even after controlling for baseline differences between groups. Conclusions: Findings suggest that untreated change from problematic alcohol use may be more intense after non-alcohol-related inpatient treatment than after having been a GP patient. Implications for brief interventions in inpatients are discussed.