Heather 1987.

Methods	Parallel RCT: Drinking Reasonably And Moderately with Self control scheme (DRAMS) versus simple advice versus non‐intervention control group. ITT: unclear.
Participants	Setting: Scotland, urban teaching primary care practices. Participants: Aged 18 to 65 years with weekly alcohol consumption > 35 units for men or > 20 units for women (1 unit = 8 g), or clinical suspicion by GP of dependence; screened by health questionnaire with alcohol consumption questions embedded. Patients with high consumption or provoking clinical suspicion were given a 10‐question DRAMS medical questionnaire by GP from which any positive response indicated eligibility; excluded if the Brief Edinburgh Alcohol Dependence Schedule showed evidence of late dependence, had known liver disease or severe mental illness, were receiving antidepressant medication, were of subnormal intelligence, were dependent on opiate drugs or were pregnant. Number randomised = 104; 75% men; mean age = 36.4 years (range 18 to 64, SD = 12.2) At baseline: mean consumption in previous month = 194.4 units; mean Michigan alcoholism score = 7.2 (SD = 5.9).
Interventions	DRAMS group (N = 34): DRAMS kit contained a four‐page introductory leaflet for GPs, a patient record card for recording patient details, results of blood tests, self‐monitored alcohol consumption and a medical questionnaire with a checklist of ten medical complications, adverse social consequences and signs of physical dependence, a two week self‐monitoring drinking diary card for use by patient, a 59 page self‐help book, a pocket‐sized and abbreviated version of the a self‐help manual for controlled drinking. Responses to 10‐item medical questionnaire were entered on the medical record card. The patient was handed the drinking diary card and asked to fill it in honestly, a follow‐up consultation in two weeks was arranged. At follow‐up the results of the blood tests and the drinking diary card were reviewed with the patient and if the existence of a drinking problem was confirmed, the doctor advised the patient to try to control the amount consumed. The patient was then introduced to the self help book and encouraged to decide on a realistic plan of action based on measures suggested in the book and using further diary sheets. Additional appointments were made at which the patients medical condition and progress at cutting down were reviewed, using the results of further blood tests Advice group (N = 32): were informed that their drinking could be harmful and were given strong advice to cut down from GP but no specific targets given and no follow‐up consultations regarding their alcohol problem were arranged. Control group (N = 38): doctor explained that the study would involve a blood test and an assessment interview, but made no specific reference to treatment or drinking and arranged no follow‐up consultations in connection with their alcohol problem.
Outcomes	Units of alcohol consumed in previous month, units of alcohol consumed in heaviest month of the previous six; control of drinking problems factor score; GGT and mean corpuscular volume, collaterals (individual known to the patient) reports of patients change in drinking. Assessed at 6 months.
Funding source	Not reported.
Declaration of interests	Not reported.
Notes	DRAMS trial Loss to follow‐up: DRAMS group: 5/34 (15%). Advice group: 2/32 (6%). Control group: 6/38 (16%).
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Unclear how randomisation sequence was generated.
Allocation concealment (selection bias)	Low risk	Unclear how allocation was concealed.
Blinding of treatment providers	High risk	Treatment providers not blinded (p. 359).
Blinding of participants	High risk	Patients were screened with a general health questionnaire but were told that the study was about the way people's drinking changes over time (p. 359).
Blinding of outcome assessment (detection bias) All outcomes	Low risk	The follow‐up interviewers were blind to patients' study groups (p. 359).
Incomplete outcome data (attrition bias) All outcomes	Low risk	Loss to follow‐up completely recorded with reasons.
Selective reporting (reporting bias)	Low risk	Outcomes specified in methods are reported.