Table 1: Critical appraisal of the major systematic reviews on alcohol brief interventions.

Author/Type of research Included trials (N) Objective/Outcome Major findings Brief intervention group vs. Control group Quality of evidence
Joseph, et al. [63] 9 RCTs Efficacy of randomized controlled trials on alcohol
brief interventions in reducing hazardous or harmful
drinking conducted at various settings of middle income
countries.
The results of five trials suggest a benefit for brief
intervention in reducing self-reported hazardous or
harmful alcohol use. The content of brief intervention
was based on the principles of motivational interviewing
and was delivered by trained nurses in almost all the trials.
Five trials reported statistically significant reductions
in self-reported alcohol consumption in the treatment
groups as compared to control group at 3 months to 24
months follow up. Four trials did not find any additional
benefit for brief intervention as both groups reduced
hazardous or harmful drinking at 6 to 12 months follow up.
Methodological quality was found to be adequate as
per standard tools, without any serious methodological
issues or biases in more than half of the selected trials.
Donoghue, et al. [40] 23 trials Effectiveness of electronic Screening and Brief
Intervention (eSBI) in non-treatment-seeking
hazardous/harmful drinkers.
eSBI resulted in a significant reduction in mean
difference in grams of ethanol consumed per week
between 3 months and less than 12 months follow-up.
A statistically significant reduction in weekly alcohol
consumption between intervention and control conditions
3,6 and less than 12 months follow-up.
Apart from the reports of large attrition rate
(up to 55%) in some trials, most of them have
acceptable methodological quality (n = 3-high
quality) as per Scottish Intercollegiate
Guidelines Network (SIGN) validated checklist.
O'Donnell, et al. [25] 24 SR (56 trials) Effectiveness of brief intervention in primary care
settings across different countries and health care
systems as per length, frequency and content of
brief intervention.
Although brief intervention is effective in primary health
care population, there is evidence gap about the
effectiveness of brief intervention regarding longevity,
frequency and content of brief intervention across
different population especially developing countries.
Not addressed specifically the superior benefit of brief
intervention group at 6-12 month follow up.
Not addressed in this review.
Kaner, et al. [23] 22 RCTs Effectiveness of brief intervention and extended
psychological interventions in primary care settings
in terms of reduction in self-reported drinking quantity,
frequency and intensity.
Brief interventions lowered alcohol consumption
especially in men at one year of follow up and
is relevant to routine clinical practice. Longer
duration of counselling probably has little
additional effect.
Serial sensitivity analyses showed a statistically
significant benefit of brief intervention group in
reduction in drinking quantity. Some trials reported
non-significant lower frequency (n = 3), intensity
(n = 5) of drinking and changes in biomarker (n = 4)
in the brief intervention group than the control group.
Methodological limitations such as absence of
adequate randomization (n = 10), allocation
concealment (n = 12) blinding was found in nearly
half of included trials. However sensitivity
analysis were restricted to trials of good
quality (n~10).
McQueen, et al. [24] 14 trials Impact of brief interventions in reducing alcohol
consumption levels, hospital re-admission rates,
alcohol related injuries and improving quality of
life with heavy alcohol users admitted to general
hospital wards.
Brief intervention resulted in reduction of alcohol
consumption and death rates of male participants in
general hospital settings at 6-9 month follow up.
The optimal content of brief intervention need further
investigation in this setting.
Superior benefit of brief intervention group at 6 month
follow up in reducing mean alcohol consumption in
grams per week (4 trials). No significant differences
between brief interventions and control groups at any
time points for; alcohol consumption based on change
scores from baseline, laboratory markers (Gamma GT),
number of binges, driving offences within 3 Years.
Methodological limitations such as absence of
adequate randomization, allocation concealment
blinding was found in nearly half of included trials.
Havard, et al. [31] 13 trials Effectiveness of Emergency Department (ED)-based
interventions in reducing alcohol consumption and
critiquing the methodological adequacy in setting.
Brief intervention did not significantly reduce subsequent
alcohol consumption in this setting, but probably effective
in reducing subsequent alcohol-related injuries.
No significant differences between brief interventions
and control groups in reducing alcohol consumption.
Methodological quality was found to be reasonable,
with the exception of poor reporting of effect-size
information and inconsistent selection of outcome
measures.