Review of Clinical Trials Testing the Effectiveness of Physician Approaches to Improving Alcohol Education and Counseling in Adolescent Outpatients

Objective: Conduct a review of clinical trials to identify effective approaches for improving physician provision of alcohol education and counseling services among outpatient adolescents. Methods: Reviewed all peer-reviewed, published clinical trials identified through computerized searches evaluating alcohol education and counseling services to outpatient adolescents by physicians. Results: Three trials were identified examining changes in physician provision of alcohol education and counseling services. One of the trials resulted in increased adolescent self-reported refusal skills, while another trial resulted in reduction of adolescent self-reported alcohol use and binge drinking. Seven trials were identified that compared physician with non-physician provision of alcohol education and counseling services. Four of the trials showed some reduction in adolescent self-reported alcohol use. Conclusion: Trials indicate that further reduction in adolescent alcohol use is possible with non-physicians as interventionists and perhaps physicians as interventionists, if physicians are supported by patient counseling guides and resources. Opportunities for personalized, interactive adolescent education with goal setting appears key to intervention success. The physician role that is tested in most trials is confined to a single brief encounter with little attention to: development of physician skills, systems-level resources, the parental role, or the impact of incorporating prevention into an ongoing adolescent-physician relationship.