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High- versus low-intensity internet interventions for alcohol use disorders: Results of a three-armed randomized controlled superiority trial.

Journal article
Authors Christoffer Sundström
Niels Eék
Martin Kraepeleien
Claudia Fahlke
M Gajecki
M Jakobson
M Beckman
Viktor Kaldo
Ann Berman
Published in Addiction
ISSN 0965-2140
Publication year 2019
Published at Department of Psychology
Language en
Links https://doi.org/10.1111/add.14871
Keywords Alcohol, Randomized Controlled Trial, Internet intervention, Alcohol use disorder, Treatment
Subject categories Psychology

Abstract

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 six months post‐randomization (primary endpoint). Settings General population sample in Sweden. Participants 166 online self‐referred adults (51% females) 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‐intensity internet intervention (n=72) and the low‐intensity internet intervention (n=71) consisted of modules based on relapse prevention. Controls were on a waitlist (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 six‐month follow‐up. Findings Alcohol use disorders were largely in the severe category (75%), with the majority of participants having had alcohol problems for more than 5 years. Follow‐up rates were 87% and 78% at the post‐treatment and six‐month follow‐up respectively. At the six‐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% CI: ‐0.50 – 0.16; heavy drinking days: d= ‐0.07, 95% CI: ‐0.40 – 0.26). Prevalence of negative effects was rather low (8‐14%) in both intervention groups, as was deterioration (3‐5%). Conclusions At six‐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.

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Utskriftsdatum: 2020-02-23