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

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.