rimary Health Care European Project on Alcohol

There is a strong evidence base for the efficacy, cost effectiveness and utility of health promotion interventions for hazardous and harmful alcohol consumption in primary health care settings. Much of this work has been undertaken through a series of international collaborative studies involving EU countries on the detection and management of alcohol-related problems in primary health care coordinated by the World Health Organization. Screening instruments have been developed and tested, the efficacy of interventions demonstrated, the current practices and perceptions of primary health care physicians assessed, and the methods for encouraging the uptake and utilizations of interventions.

The challenge of the Phepa Project is to integrate health promotion interventions for hazardous and harmful alcohol consumption into primary health care professionals’ daily clinical work. It will achieve this by preparing:

  • European recommendations and clinical guidelines
  • a training program for primary health care professionals;
  • a comprehensive Internet site database on good practice,
  • a series of country specific dissemination strategies.

The Project aim supports the European Community’s Public Health Strategy and the European Charter on Alcohol and the European Alcohol Action Plan, of the World Health Organization.

Partners of The Phepa Project

Spain (Catalonia)

Czech Republic
European WONCA


Clinical Guidelines and Recommendations

PHC settings are in a pivotal position for early detection and brief intervention with risky drinkers and the prevention of alcohol related harm

To provide evidence-based information and to raise awareness on alcohol-related issues, specially in the area of risky drinking, among PHC professionals.

The clinical guidelines include:

  • A set of statements about appropriate health care to support daily practice, based on evidence and critical appraisal.
  • A set of recommendations to assist practitioner and patient decisions about appropriate health care for the management of alcohol problems

Training Manual for managing hazardous and harmful alcohol consumption

The aims of the Training Manual are:

  • To enhance the skills of PHC professionals in the management of alcohol-related issues.
  • To provide policy makers and Health Authorities with a tool that allows them to promote the dissemination of SBI techniques in PHC settings.

It represents a challenge as:

  • PHC workers lack training in alcohol issues and specially in SBI techniques
  • PHC workers are overloaded by their clinical work. Time is a main constraint.
  • Motivation is a key issue both in GPs and patients.

The training manual is being developed under the following principles:

  • Be clear, simple and flexible
  • Help GPs to solve already existing problems. Takes into account resistances against screening
  • Be delivered in few hours and integrated in the regular CME
  • Be adaptable to self-training formats
  • Provide user friendly tools & materials that can be used in the daily practice


  • Introduction and basic concepts.
  • Screening tools
  • Brief advice and assessment techniques for risky drinkers
  • Alcohol Dependence

Internet Web Site

phepa website

Comprehensive Internet site database on good practice, providing the evidence base in the domains of efficacy, economics, health and policy

Implementation in Countries

One of the project aims is to convene 13 country based teams to develop a country based strategy for the implementation of the programme to integrate interventions for hazardous and harmful alcohol consumption in primary health care settings.

The exact numbers and composition of the country based teams will vary from country to country, but include representation of: 1) Governmental organizations, 2) Non-governmental organizations, 3) Health professional organizations and/or groups and 4) Scientific organizations and/or groups.

The programmes will have a prevention and health promotion focus and will include targeted approaches for young people. The aim is to have the strategy endorsed by a number of key partners and stakeholders in each and to present to the country’s Ministry of Health.