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Effect of motivational interviewing on reduction of alcohol use.

ABSTRACT: Methadone-maintained (MM) clients who engage in excessive alcohol use are at high risk for HIV and hepatitis B virus (HBV) infection. Nurse-led hepatitis health promotion (HHP) may be one strategy to decrease alcohol use in this population.To evaluate the impact of nurse-led HHP, delivered by nurses compared to motivational interviewing (MI), delivered by trained therapists in group sessions or one-on-one on reduction of alcohol use.A three-arm randomized, controlled trial, conducted with 256 MM adults attending one of five MM outpatient clinics in the Los Angeles area. Within each site, moderate-to-heavy alcohol-using MM participants were randomized into one of three conditions: (1) nurse-led hepatitis health promotion group sessions (n=87); (2) MI delivered in group sessions (MI-group; n=79), or (3) MI delivered one-on-one sessions (MI-single, n=90).Self-reported alcohol use was reduced from a median of 90 drinks/month at baseline to 60 drinks/month at 6-month follow-up. A Wilcoxon sign-rank test indicated a significant reduction in alcohol use in the total sample (p<.05). In multiple logistic regression analysis controlling for alcohol consumption at baseline and other covariates, no differences by condition were found.As compared to two programs delivered by MI specialists, a culturally-sensitive and easy to implement nurse-led HHP program produced similar reductions in alcohol use over 6 months. Employing nurse-led programs may allow cost savings for treatment programs as well as a greater integration of alcohol reduction counseling along with a more comprehensive focus on general health-related issues than previously conducted.

SUBMITTER: Nyamathi A

PROVIDER: S-EPMC3383096 | biostudies-literature | 2010 Feb

REPOSITORIES: biostudies-literature

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Effect of motivational interviewing on reduction of alcohol use.

Nyamathi Adeline A Shoptaw Steven S Cohen Allan A Greengold Barbara B Nyamathi Kamala K Marfisee Mary M de Castro Viviane V Khalilifard Farinaz F George Daniel D Leake Barbara B

Drug and alcohol dependence 20100201 1

<h4>Background</h4>Methadone-maintained (MM) clients who engage in excessive alcohol use are at high risk for HIV and hepatitis B virus (HBV) infection. Nurse-led hepatitis health promotion (HHP) may be one strategy to decrease alcohol use in this population.<h4>Objective</h4>To evaluate the impact of nurse-led HHP, delivered by nurses compared to motivational interviewing (MI), delivered by trained therapists in group sessions or one-on-one on reduction of alcohol use.<h4>Methods</h4>A three-ar ...[more]

PMID: 19836904

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Project description:AimTo test the effectiveness of a motivational interviewing (MI) intervention using the mobile phone among adults with alcohol use problems.DesignA randomized clinical trial of mobile MI and standard in-person MI with 1- and 6-month follow-up, including a 1-month waitlist control followed by mobile MI.SettingA primary health center in rural Kenya.ParticipantsThree hundred adults screening positive for alcohol use problems were randomized and received immediate mobile MI (n = 89), in-person MI (n = 65) or delayed mobile MI (n = 76) for waiting-list controls 1 month after no treatment, with 70 unable to be reached for intervention.Intervention and comparatorOne MI session was provided either immediately by mobile phone, in-person at the health center or delayed by 1 month and then provided by mobile phone.MeasurementsAlcohol use problems were repeatedly assessed using the Alcohol Use Disorder Identification Test (AUDIT) and the shorter AUDIT-C. The primary outcome was difference in alcohol score 1 month after no intervention for waiting-list control versus 1 month after MI for mobile MI. The secondary outcomes were difference in alcohol score for in-person MI versus mobile MI one and 6 months after MI.FindingsFor our primary outcome, average AUDIT-C scores were nearly three points higher (difference = 2.88, 95% confidence interval = 2.11, 3.66) for waiting-list controls after 1 month of no intervention versus mobile MI 1 month after intervention. Results for secondary outcomes supported the null hypothesis of no difference between in-person and mobile MI at 1 month (Bayes factor = 0.22), but were inconclusive at 6 months (Bayes factor = 0.41).ConclusionMobile phone-based motivational interviewing may be an effective treatment for alcohol use problems among adults visiting primary care in Kenya. Providing mobile motivational interviewing may help clinicians in rural areas to reach patients needing treatment for alcohol use problems.

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Effect of motivational interviewing on reduction of alcohol use.

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Effect of motivational interviewing on reduction of alcohol use.

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