Thirteen articles (4,140 patients) were included. Sample sizes ranged from 28 to 1,329 patients. Seven studies were considered fair quality and six were considered poor quality.
Non-physician clinician interventions, compared to controls, were associated with a significant reduction in the mean standard drinks per week by 1.7 standard drinks (95% CI -0.03 to -3.5, I2=46.8%; seven studies, 2,210 patients). No evidence of publication bias was found.
Excluding one study that contributed disproportionate heterogeneity to the analysis resulted in a smaller reduction in the mean standard drinks per week (mean reduction 1.36, 95% CI 0.3 to -2.4).
Head-to-head comparisons of physician and non-physician clinician interventions (three studies) revealed that alcohol consumption decreased in both groups and no between-group differences.
Physician combined with non-physician interventions were compared to physician clinician-only interventions in two studies. One study found that alcohol consumption decreased in both groups and no between-group differences. The other study found that non-physician interventions were associated with a significant reduction in alcohol consumption at six-month (p=0.001) and 12-month (p=0.03) follow-up.