Risky Drinkers and the Web: a RCT Study in Region Friuli-Venezia Giulia.

Excessive Drinking

Alcohol, Risky drinking, Web site, Primary Care, General Practice, Local Community, Mayors

The project aims to develop a new approach to risky drinkers by providing a facilitated website access and creating a local integrated support network. In order to do so: 1\) A non inferiority-randomised controlled study will be performed to test the hypothesis that: Brief intervention for risky drinkers delivered in primary care through facilitated access to an alcohol reduction website has non inferior outcomes to face to face brief intervention.

Far from being only an Italian problem, harmful alcohol consumption puts a heavy burden on people's health. Risky behaviors and socio-economical conditions are closely linked and, thus, during critical economical periods, such as this, alcohol related problems increase significantly. Screening and Brief Intervention is a very effective method to screen and counsel risky people at primary care level but, nevertheless, general practitioners and other health care professionals don't utilize it. This is mainly due to the fact that the National Health Services should include it into financial agreements for reimbursement or adopt other incentives that, in this critic period, are difficult to be taken into consideration. What are the alternatives? Utilizing existing resources to propose a different approach at little or no cost: the web and the local communities. Computers are in almost every house and, if not, the local community can offer their use within libraries or social centres. Computers are definitely utilized by young people and youngsters are the first to suffer from risky alcohol use. Older people are more and more using them maybe just to surf the web but, if not, its use could be facilitated by their general practitioners. As stated before, no scientific evidence exists on its effectiveness in respect to the GPs work. For this reason we decided to compare the efficacy of a web based brief intervention with a face-to-face brief intervention performed by general practitioners. We would like to see if a web based approach is, at least, as good as, or not inferior to GPs work. This project could have an important impact at regional and national level. It could be the starting point of a different way to provide alcohol related health services, utilizing up to date working tools, such as smart phones or iPads, giving a different role to the GPs and improving the action of local social services. The work of general practitioners could also benefit and more integration with the territorial services could bring to increased visibility of Local Authorities. The supervision of national and international high-level experts will assure an outstanding quality to the project and the possibility of future inclusion of its results within national or international guidelines for primary care alcohol related services. This study is a part of a wider community program aiming at involving GPs and Local Authorities for its implementation whose objectives are out of the scope of this RCT.

Italy