A randomized controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website (EFAR Spain)
| Autor: | Lidia Segura, Josep Ramon López Olivares, María del Carmen Martí Martínez, Cristina Ligero, Rosa María González Cabezas, Juan Manuel Mendive Arbeloa, Natalia Sabat Vila, Marta R. Solé Dalfó, Renée Vink Schoenholzer, Antonia Leiva Pintado, MªCarme Parareda Plana, Eva María Ramírez Moreno, Olga Bohera Gracia, Marta Poch i Mora, Montserrat Espuga García, Almudena Alvarez, Manel Vila Vergaz, Paul K. Wallace, Gemma Comas Arnau, Montserrat Navarro Gilo, Nora Yanovksy Martí, Carme Danta Gómez, Sonia Martínez Lainez, Estela Díaz, Antoni Gual, Iris Alarcón Belmonte, José Francisco Doz Mora, Ana Morillo Ortega, Fernando Ferrer Keysers, Gemma Castillo Tirado, Susana Sostres Francás, María del Mar Sánchez Hernández, Francisco Cortés Hurtado, Silvia Crivillé Mauricio, Pere Sors i Cuffi, Mercè Ribot Igualada, M. Isabel Matilla Mont, Begoña Baena, Esther Bracero Alonso, Olga Navarro Martinez, Clara Calvó Blancafort, Angels Vicente Zamorano, Marta Beltran Vilella, M. Carmen Sánchez Herrero, Meritxell Ferrer Pujol, Rosa Blanca Muñoz Muñoz, M. Isabel López Castelló, Rosa Pla Martínez, Nuria Garcia Moron, Monica Mestres Massa, Elena Navarro Pou, Josep Maria Gifre Hipolit, Elena Campanera Samitier, Alicia Gómez Arroyo, Esther Boix Roqueta, Jakob Manthey, Elena Casajuana Andres, Rosaura Figueras Camós, Anna Santeugini Bosch, Teresa Sayrol Clols, Hugo López-Pelayo, Mireia Bernat Casals, Clara Oliveras, Angel Garcia Vilaubí, Núria Plana Closa, Carmen Garcia Corominas, Eva Casajuana Andres, Cleofé Mellado Rodríguez, Maite Fernandez Orriols, Marta Mas Regàs, Remedios Miralles Bacete, Carme Anglada Arisa, Juan Arenas Vidal, Montse Mendez Ribas, Silvia Duran Alcobet, Eulalia Duran Bellido, Davinia Vazquez Gonzalez, Xavier Cantano Navarro, Francisco Javier Avila Rivera, Gemma Capdevila Rodriguez, Elena Mañes López, Gloria Ribas Miquel, Elisenda Garcia Puig, Elvira Pou Rovira, Carme Comino Cereto, Carme Codorniu Junqué, Joan Colom, Pilar Flores Figueres, Dolors Ylla Murillo, Joana Hernandez Millan, Roser Urpinas Vilà, M. de la Serra Comas i Antich, Andrea Carolina Berengue Gonzalez, Beatriz Fernandez Najar, Elsa Caballeria, Cristina Bonaventura Sans, Judit Alsina Massana, Maria de las Nieves Vizcay Cruchaga, Pau Montoya Roldan, María Concepción Lasmarías Ugarte, Rosa Freixedas Casaponsa, M. Montserrat Melé Baena |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Alcohol Use Disorders Identification Test business.industry Confounding Psychological intervention Health Informatics Information technology Audit T58.5-58.64 Missing data Full length Article BF1-990 law.invention Risky alcohol use Randomized controlled trial Screening and brief intervention law Intervention (counseling) Physical therapy eHealth Psychology Medicine business Primary healthcare |
| Zdroj: | Internet Interventions Internet Interventions, Vol 26, Iss, Pp 100446-(2021) |
| ISSN: | 2214-7829 |
| Popis: | Background Brief interventions (BI) for risky drinkers in primary healthcare have been demonstrated to be cost-effective but they are still poorly implemented. Digital BI seems to be a complementary strategy to overcome some barriers to implementation but there is a scarcity of studies in clinical environments. We present the results of a randomized controlled non-inferiority trial which tests the non-inferiority of facilitated access to a digital intervention (experimental condition) for risky drinkers against a face-to-face BI (control condition) provided by primary healthcare professionals. Method In a non-inferiority randomized controlled trial, unselected primary healthcare patients (≥ 18 years old) were given a brief introduction and asked to log on to the study website to fill in the 3-item version of the Alcohol Use Disorders Identification Test. Positively screened patients (4+ for women and 5+ for men) received further online assessment (AUDIT, socio-demographic characteristics and EQ-5D-5L) and were automatically randomized to either face-to-face or digital BI (1:1). The primary outcome was the proportion of patients classified as risky drinkers by the digitally administered AUDIT at month 3. A multiple imputation approach for the missing data was performed. Results Of the 4499 patients approached by 115 healthcare professionals, 1521 completed the AUDIT-C. Of the 368 positively screened patients, 320 agreed to participate and were randomized to either intervention. At month 3, there were more risky drinkers in the experimental group (59.8%) than in the control group (52%), which was similar to the distribution at baseline and less than the pre-specified margin of 10%. The difference was not significant when accounting for possible confounders. Conclusion Digital BI was not inferior to face-to-face BI, in line with previous findings and the a priori hypothesis. However, the low power of the final sample, due to the low recruitment and loss to follow-up, limits the interpretation of the findings. New approaches in this field are required to ensure the effective implementation of digital interventions in actual practice. Highlights • Early identification and Brief Intervention is a cost-effective approach to risky drinkers in primary healthcare. • In our trial, digital Brief Intervention was not inferior to face-to-face Brief Intervention. • Several barriers hinder the engagement with Digital Brief Interventions. • New approaches in this field are required to ensure the effective implementation of digital intervention in real practices. |
| Databáze: | OpenAIRE |
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