PMID- 18201645
OWN - NLM
STAT- MEDLINE
DCOM- 20080331
LR  - 20220310
IS  - 0749-3797 (Print)
IS  - 0749-3797 (Linking)
VI  - 34
IP  - 2
DP  - 2008 Feb
TI  - Primary care intervention to reduce alcohol misuse ranking its health impact and 
      cost effectiveness.
PG  - 143-152
LID - 10.1016/j.amepre.2007.09.035 [doi]
AB  - BACKGROUND: The U.S. Preventive Services Task Force (USPSTF) has recommended 
      screening and behavioral counseling interventions in primary care to reduce 
      alcohol misuse. This study was designed to develop a standardized rating for the 
      clinically preventable burden and cost effectiveness of complying with that 
      recommendation that would allow comparisons across many recommended services. 
      METHODS: A systematic review of the literature from 1992 through 2004 to identify 
      relevant randomized controlled trials and cost-effectiveness studies was 
      completed in 2005. Clinically preventable burden (CPB) was calculated as the 
      product of effectiveness times the alcohol-attributable fraction of both 
      mortality and morbidity (measured in quality-adjusted life years or QALYs), for 
      all relevant conditions. Cost effectiveness from both the societal perspective 
      and the health-system perspective was estimated. These analyses were completed in 
      2006. RESULTS: The calculated CPB was 176,000 QALYs saved over the lifetime of a 
      birth cohort of 4,000,000, with a range in sensitivity analysis from -43% to +94% 
      (primarily due to variation in estimates of effectiveness). Screening and brief 
      counseling was cost-saving from the societal perspective and had a 
      cost-effectiveness ratio of $1755/QALY saved from the health-system perspective. 
      Sensitivity analysis indicates that from both perspectives the service is very 
      cost effective and may be cost saving. CONCLUSIONS: These results make alcohol 
      screening and counseling one of the highest-ranking preventive services among the 
      25 effective services evaluated using standardized methods. Since current levels 
      of delivery are the lowest of comparably ranked services, this service deserves 
      special attention by clinicians and care delivery systems.
FAU - Solberg, Leif I
AU  - Solberg LI
AD  - HealthPartners Research Foundation, Minneapolis, Minnesota 55440-1524, USA. 
      leif.i.solberg@healthpartners.com
FAU - Maciosek, Michael V
AU  - Maciosek MV
FAU - Edwards, Nichol M
AU  - Edwards NM
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Review
PT  - Systematic Review
PL  - Netherlands
TA  - Am J Prev Med
JT  - American journal of preventive medicine
JID - 8704773
SB  - IM
MH  - Alcoholism/*prevention & control
MH  - Cost-Benefit Analysis
MH  - Counseling/*economics/methods
MH  - Humans
MH  - *Primary Health Care/economics
MH  - Quality-Adjusted Life Years
MH  - United States
RF  - 127
EDAT- 2008/01/19 09:00
MHDA- 2008/04/01 09:00
CRDT- 2008/01/19 09:00
PHST- 2007/03/23 00:00 [received]
PHST- 2007/08/21 00:00 [revised]
PHST- 2007/09/26 00:00 [accepted]
PHST- 2008/01/19 09:00 [pubmed]
PHST- 2008/04/01 09:00 [medline]
PHST- 2008/01/19 09:00 [entrez]
AID - S0749-3797(07)00686-1 [pii]
AID - 10.1016/j.amepre.2007.09.035 [doi]
PST - ppublish
SO  - Am J Prev Med. 2008 Feb;34(2):143-152. doi: 10.1016/j.amepre.2007.09.035.