Abstract

Background: In Chile, alcohol use is the leading cause of years lost due to disability. To address this issue, the Health Ministry has implemented a national program on Brief Interventions (BI) for Risky Alcohol use, in which Paramedics are the main BI providers. The objective of this work is to study the effectiveness of non-professional delivered BIs as they occur in the real world in Chilean primary care. Materials and Methods: A multi-center randomized open-label controlled trial was conducted in five primary care centers in Santiago de Chile. A total of 3247 people aged 18–45 were screened for moderate-risk alcohol use according to AUDIT (Alcohol Use Disorders Identification Test), and 343 participants were randomized. The paramedic-delivered BI (n = 174) was compared to an informative pamphlet (n = 169). The outcome measure was the AUDIT score at baseline and six months follow-up. Results: From the total people screened, 11% were at moderate risk for alcohol use (AUDIT 8–15), and 2% at high risk (AUDIT over 15). Recruited participants had a mean age of 29 years, 57% were male, and the average AUDIT score was 10.5 (SD 2.6), which did not differ between groups. Changes to the “real practice” conditions had to be made to permit full protocol implementation. Lack of time, competition with other tasks, and lack of space were some of the problems for screening procedures and delivery of BI. 58 paramedics were trained on AUDIT and BI delivery, and 32 reached the standards to participate in the study. Additional training was needed to ensure proper AUDIT administration and BI structure. Only 10 paramedics finally participated in the study, mainly due to administrative constraints. To date, 120 participants have completed follow-up. The mean AUDIT score at follow-up is 6.2 for all participants, with no significant differences observable between groups so far. Conclusions: Paramedics can implement AUDIT linked BIs, but they need special training and accommodation to integrate it into their practice and tasks. Both groups had lower AUDIT scores (by 4 points), but completion of follow-up is necessary to determinate if there is an effect attributable to BI.