Community pharmacy staff are used to handling queries in a sensitive manner, but usually these queries are prompted by the individual themselves. In the case of an alcohol IBA service, both the screening and the offering of advice is initiated by a pharmacy team member, and for this reason people may react in a variety of different ways. Some people will find it difficult to talk about their drinking so it is essential that you approach any conversation in a professional, non-judgemental manner.

Before you can offer brief advice, you need to be well prepared. It is also important to have an appreciation of how prepared the individual is to change their behaviour. People will vary in their readiness to change, and the 'stages of change' is a useful model that explains the process of decision-making in relation to change. There are generally three stages: pre-contemplation, contemplation and action. The stage in the cycle the individual has reached will ultimately determine how they respond to advice and how motivated they are to make changes to their behaviour, so this should be taken into account when giving advice.

Structuring brief advice

There are a number of ways to structure brief advice for individuals who are drinking at increasing risk or higher risk levels, including: 

• Giving feedback about their level of drinking
• Providing information (e.g. about the common effects of drinking and the benefits of reduction)
• Explaining the concept of a unit of alcohol 
• Giving advice on sensible limits 
• Establishing a goal or goals for the individual to change their drinking behaviour
• Providing encouragement and the option for a follow up.

The NHS has produced a leaflet to help structure the advice given.

While the focus of an alcohol IBA service is to offer brief advice to people who are found to be drinking at an increasing risk or higher risk level, it is important that the pharmacy team also supports and educates those who are found to be drinking at the lower risk level. They may, after all, need help in the future if they are unaware of the risks. These discussions should follow a similar structure to the one outlined above.