Effectiveness of brief motivational interviewing for alcohol misuse: a systematic review of randomized controlled trials.

Background: Alcohol misuse remains a major global public health concern. Brief motivational interviewing (BMI) is a time-efficient, patient-centered intervention for reducing hazardous and harmful alcohol use. Methods: This systematic review synthesized evidence from 32 randomized controlled trials published between 2015 and 2025 evaluating BMI interventions for alcohol misuse in adults. Studies involving university students, emergency department patients, individuals with psychiatric or medical comorbidities, and socially vulnerable populations were included. Results: BMI was generally associated with reductions in alcohol consumption, binge drinking frequency, heavy drinking days, alcohol-related consequences, and Alcohol Use Disorders Identification Test (AUDIT) scores. Effects were more consistently observed among university students and emergency department populations, whereas findings were more variable among individuals with psychiatric comorbidity or social vulnerability. Technology-assisted and hybrid BMI approaches demonstrated short-term effectiveness comparable to traditional face-to-face delivery, although intervention effects frequently attenuated beyond 6-12 months. Conclusions: BMI appears to be a flexible and clinically meaningful intervention for reducing alcohol-related harm across diverse adult populations. However, long-term benefits were less consistently maintained, suggesting that ongoing support strategies, such as booster contacts, digital monitoring, or continued clinician involvement, may be important for sustaining behavioral change over time.