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High‐ versus low‐intensity internet interventions for alcohol use disorders: results of a three‐armed randomized controlled superiority trial
Author(s) -
Sundström Christopher,
Eék Niels,
Kraepelien Martin,
Fahlke Claudia,
Gajecki Mikael,
Jakobson Miriam,
Beckman Maria,
Kaldo Viktor,
Berman Anne H.
Publication year - 2020
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.14871
Subject(s) - randomized controlled trial , medicine , alcohol use disorders identification test , psychological intervention , brief intervention , population , alcohol use disorder , randomization , alcohol dependence , alcohol consumption , psychiatry , alcohol , physical therapy , poison control , injury prevention , emergency medicine , environmental health , biochemistry , chemistry
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.