[Effectiveness of medical counseling for alcoholic patients and patients with excessive alcohol consumption seen in primary care]

AIM

To determine the effectiveness of medical counseling for alcohol abuse, when it is provided in primary care centers.

DESIGN

Quasi-experimental, open, multicenter before-after study.Setting. 14 primary care physician's practices (7 rural, 7 urban) in the province of Córdoba (Spain).

PARTICIPANTS

306 patients of both sexes, recruited with a case-finding strategy, who consumed >=35 (men) or >=21 (women) IU per week, or who had alcohol dependence syndrome (ADS) (MALTS score O>=11). Interventions. All patients were offered brief counseling to reduce drinking, and all were followed to evaluate their status 3 months, 1 year and 2 years later.

MAIN MEASURES

The response variable was self-reported alcohol consumption together with normal GGT values or confirmation of alcohol consumption by a relative. The results were subjected to intention-to-treat analysis.

RESULTS

Of the 306 patients included in the study, 95.1% were men and 78.4% had ADS. After 2 years 38.89% (95% CI, 32.2%-44.3%) had attained their treatment goal: 23.85% were in complete abstinence, and 15.0% consumed moderate amounts of alcohol below the limit considered to indicate risk. Starting excessive consumption at less than 16 years of age (odds ratio [OR], 3.0885), living in a slum (OR, 3.2103), smoking (OR, 1.7187), and a positive CAGE test (OR, 1.9949) were associated with failure of the intervention (P<.05).

CONCLUSIONS

Counseling provided by the family doctor was highly effective under the usual conditions of general practice, both for patients with excessive alcohol consumption and for patients with con ADS.

[Use of guar gum as a supplement to the usual diet in type 2 diabetes. A long-term study]

The effects of diet supplementation with guar rubber in granules (15 g/day, divided in three doses with the major meals) were compared during 3 months with a control group in a randomized study. Thirty-five type II diabetic patients were randomized into two groups (guar and control) of 16 and 19 patients, respectively. The patients in the guar group showed an improvement in the carbohydrate and lipid metabolism as compared with the control group; however, in our opinion, this improvement was not important enough to recommend the routine use of guar rubber in the diet of the diabetic patient owing to its poor acceptance.