High‐ versus low‐intensity internet interventions for alcohol use disorders: results of a three‐armed randomized controlled superiority trial

Autor: Niels Eék, Anne H. Berman, Claudia Fahlke, Maria Beckman, Martin Kraepelien, Mikael Gajecki, Viktor Kaldo, Miriam Jakobson, Christopher Sundström
Rok vydání: 2020
Předmět:
Adult
Male
Research Report
medicine.medical_specialty
treatment
cognitive behavior therapy
Alcohol Drinking
Psychological intervention
030508 substance abuse
Medicine (miscellaneous)
Alcohol
Alcohol use disorder
alcohol use disorder
Relapse prevention
law.invention
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Randomized controlled trial
law
Internal medicine
medicine
Humans
030212 general & internal medicine
Sweden
Alcohol Use Disorders Identification Test
Cognitive Behavioral Therapy
business.industry
Research Reports
Middle Aged
medicine.disease
Confidence interval
Substance abuse
Alcoholism
Psychiatry and Mental health
internet intervention
chemistry
randomized controlled trial
Female
Self Report
0305 other medical science
business
Internet-Based Intervention
Zdroj: Addiction (Abingdon, England)
ISSN: 1360-0443
0965-2140
Popis: Aims To test the efficacy of a therapist-guided high-intensity internet intervention compared with an unguided low-intensity internet intervention among individuals with alcohol use disorder. Design A three-group randomized controlled trial with follow-up assessments post-treatment (12 weeks) and 6 months post-randomization (primary end-point). Settings General population sample in Sweden. Participants A total of 166 on-line self-referred adults (49% males) with a score of 14 (females)/16 (males) or more on the Alcohol Use Disorders Identification Test, a preceding week alcohol consumption of 11 (females)/14 (males) or more standard drinks and an alcohol use disorder according to a diagnostic interview. Interventions and comparators Both the high- (n = 72) and low-intensity internet interventions (n = 71) consisted of modules based on relapse prevention. Controls were on a waiting-list (n = 23), and were only followed until the post-treatment follow-up. Participants were randomized at a 7 : 7 : 2 ratio. Measurements Primary outcome was self-reported alcohol consumption in the preceding week measured as (1) number of standard drinks and (2) number of heavy drinking days at the 6-month follow-up. Findings Alcohol use disorders were largely in the severe category (74.7%), with the majority of participants having had alcohol problems for more than 5 years. Attrition was 13 and 22% at the post-treatment and 6-month follow-up, respectively. At the 6-month follow-up, an intent-to-treat analysis showed no significant differences in alcohol consumption between the high- and low-intensity interventions [standard drinks d = -0.17, 95% confidence interval (CI) = -0.50 to 0.16; heavy drinking days: d = -0.07, 95% CI = -0.40 to 0.26]. Prevalence of negative effects was somewhat low (8-14%) in both intervention groups, as was deterioration (3-5%). Conclusions At 6-month follow-up, there were no significant differences between a therapist-guided high-intensity internet intervention and an unguided low-intensity internet intervention in reducing alcohol consumption among individuals with an alcohol use disorder.
Databáze: OpenAIRE
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