Automated telephone interventions for problematic alcohol use in clinical and population samples: a randomized controlled trial

Claes Andersson, Mikael Gajecki, Agneta Öjehagen, Anne H Berman, Claes Andersson, Mikael Gajecki, Agneta Öjehagen, Anne H Berman

Abstract

Objective: The primary objective was to evaluate 6-month outcomes for brief and extensive automated telephony interventions targeting problematic alcohol use, in comparison to an assessment-only control group. The secondary objective was to compare levels of problematic alcohol use (hazardous, harmful or probable dependence), gender and age among study participants from clinical psychiatric and addiction outpatient settings and from population-based telephone helpline users and Internet help-seeker samples.

Results: The Alcohol Use Disorders Identification Test (AUDIT) was used for screening of problematic alcohol use and 6-month follow-up assessment. A total of 248 of help-seekers with at least hazardous use (AUDIT scores of ≥ 6/≥ 8 for women/men) were recruited from clinical and general population settings. Minor recruitment group differences were identified with respect to AUDIT scores and age at baseline. One hundred and sixty persons (64.5%) did not complete the follow-up assessment. The attrition group had a higher proportion of probable dependence (71% vs. 56%; p = 0.025), and higher scores on the total AUDIT, and its subscales for alcohol consumption and alcohol problems. At follow up, within-group problem levels had declined across all three groups, but there were no significant between-group differences. Trial registration ClinicalTrials.gov NCT01958359, Registered October 9, 2013. Retrospectively registered.

Keywords: Addiction; Alcohol; Automated; Dependence; Hazardous; Help seekers; Intervention; Outpatient; Psychiatry; Randomized; Telephone.

Figures

Fig. 1
Fig. 1
Consort diagram of the trial. Shaded areas were not included in analyses

References

    1. Eberhard S, Nordström G, Öjehagen A. Hazardous alcohol use in general psychiatric outpatients. J Mental Health. 2015;24(3):162–167. doi: 10.3109/09638237.2015.1036967.
    1. Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the epidemiologic catchment area (ECA) study. JAMA. 1990;264(19):2511–2518. doi: 10.1001/jama.1990.03450190043026.
    1. Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 alcohol use disorder: results from the national epidemiologic survey on alcohol and related conditions III. JAMA Psychiatry. 2015;72(8):757–766. doi: 10.1001/jamapsychiatry.2015.0584.
    1. Cohen E, Feinn R, Arias A, Kranzler HR. Alcohol treatment utilization: findings from the national epidemiologic survey on alcohol and related conditions. Drug Alcohol Depend. 2007;86(2):214–221. doi: 10.1016/j.drugalcdep.2006.06.008.
    1. Rehm J, Shield K, Rehm M, Gmel G, Frick U. Alcohol consumption, alcohol dependence, and attributable burden of disease in Europe: Potential gains from effective interventions for alcohol dependence. Centre for Addiction and Mental Health. 2012. . Accessed 25 Nov 2017.
    1. Probst C, Manthey J, Martinez A, Rehm J. Alcohol use disorder severity and reported reasons not to seek treatment: a cross-sectional study in European primary care practices. Subst Abuse Treat Prev Policy. 2015;10(1):32. doi: 10.1186/s13011-015-0028-z.
    1. Schomerus G, Lucht M, Holzinger A, Matschinger H, Carta MG, Angermeyer MC. The stigma of alcohol dependence compared with other mental disorders: a review of population studies. Alcohol Alcohol. 2011;46(2):105–112. doi: 10.1093/alcalc/agq089.
    1. Bien TH, Miller WR, Tonigan JS. Brief interventions for alcohol problems: a review. Br J Addict. 1993;88:315–336. doi: 10.1111/j.1360-0443.1993.tb00820.x.
    1. Riper H, Blankers M, Hadiwijaya H, Cunningham J, Clarke S, Wiers R, Ebert D, Cuijpers P. Effectiveness of guided and unguided low-intensity internet interventions for adult alcohol misuse: a meta-analysis. PLoS ONE. 2014;9(6):e99912. doi: 10.1371/journal.pone.0099912.
    1. Wallhed Finn S, Bakshi AS, Andreasson S. Alcohol consumption, dependence, and treatment barriers: perceptions among nontreatment seekers with alcohol dependence. Subst Use Misuse. 2014;49(6):762–769. doi: 10.3109/10826084.2014.891616.
    1. Buscemi J, Murphy JG, Martens MP, McDevitt-Murphy ME, Dennhardt AA, Skidmore JR. Help-seeking for alcohol-related problems in college students: correlates and preferred resources. Psychol Addict Behav. 2010;24(4):571. doi: 10.1037/a0021122.
    1. Sundström C, Blankers M, Khadjesari Z. Computer-based interventions for problematic alcohol use: a review of systematic reviews. Int J Behav Med. 2016;24(5):646–658. doi: 10.1007/s12529-016-9601-8.
    1. Radtke T, Ostergaard M, Cooke R, Scholz U. Web-based alcohol intervention: study of systematic attrition of heavy drinkers. J Med Internet Res. 2017;19(6):e217. doi: 10.2196/jmir.6780.
    1. McCambridge J, Kypri K. Can simply answering research questions change behaviour? Systematic review and meta analyses of brief alcohol intervention trials. PLoS ONE. 2011;6(10):e23748. doi: 10.1371/journal.pone.0023748.
    1. Schrimsher GW, Filtz K. Assessment reactivity: can assessment of alcohol use during research be an active treatment? Alcohol Treat Q. 2011;29(2):108–115. doi: 10.1080/07347324.2011.557983.
    1. Clifford PR, Davis CM. Alcohol treatment research assessment exposure: a critical review of the literature. Psychol Addict Behav. 2012;26(4):773–781. doi: 10.1037/a0029747.
    1. Andersson C, Danielsson S, Silfverberg-Dymling G, Löndahl G, Johansson BA. Evaluation of interactive voice response (IVR) and postal survey in follow-up of children and adolescents discharged from psychiatric outpatient treatment: a randomized controlled trial. SpringerPlus. 2014;3(1):77. doi: 10.1186/2193-1801-3-77.
    1. Sinclair M, O’Toole J, Malawaraarachchi M, Leder K. Comparison of response rates and cost-effectiveness for a community-based survey: postal, internet and telephone modes with generic or personalised recruitment approaches. BMC Med Res Methodol. 2012;12(1):132. doi: 10.1186/1471-2288-12-132.
    1. Andersson C, Söderpalm Gordh AHV, Berglund M. Use of real-time interactive voice response in a study of stress and alcohol consumption. Alcohol Clin Exp Res. 2007;31(11):1908–1912. doi: 10.1111/j.1530-0277.2007.00520.x.
    1. Sinadinovic K, Wennberg P, Berman AH. Population screening of risky alcohol and drug use via internet and interactive voice response (IVR): a feasibility and psychometric study in a random sample. Drug Alcohol Depend. 2011;114:55–60. doi: 10.1016/j.drugalcdep.2010.09.004.
    1. Simpson TL, Stappenbeck CA, Varra AA, Moore SA, Kaysen D. Symptoms of posttraumatic stress predict craving among alcohol treatment seekers: results of a daily monitoring study. Psychol Addict Behav. 2012;26(4):724–733. doi: 10.1037/a0027169.
    1. Mundt JC, Moore HK, Bean P. An interactive voice response program to reduce drinking relapse: a feasibility study. J Subst Abuse Treat. 2006;30:21–29. doi: 10.1016/j.jsat.2005.08.010.
    1. Helzer JE, Rose GL, Badger GJ, Searles JS, Thomas CS, Lindberg SA, Guth S. Using interactive voice response to enhance brief alcohol intervention in primary care settings. J Stud Alcohol Drugs. 2008;69(2):251–258. doi: 10.15288/jsad.2008.69.251.
    1. Rose GL, MacLean CD, Skelly J, Badger GJ, Ferraro TA, Helzer JE. Interactive voice response technology can deliver alcohol screening and brief intervention in primary care. J Gen Intern Med. 2010;25(4):340–344. doi: 10.1007/s11606-009-1233-0.
    1. Rose GL, Skelly JM, Badger GJ, Naylor MR, Helzer JE. Interactive voice response for relapse prevention following cognitive-behavioral therapy for alcohol use disorders: a pilot study. Psychol Serv. 2012;9(2):174–184. doi: 10.1037/a0027606.
    1. Moore BA, Fazzino T, Barry DT, Fiellin DA, Cutter CJ, Schottenfeld RS, Ball SA. The recovery line: a pilot trial of automated, telephone-based treatment for continued drug use in methadone maintenance. J Subst Abuse Treat. 2013;45(1):63–69. doi: 10.1016/j.jsat.2012.12.011.
    1. Schroder KEE, Tucker JA, Simpson CA. Telephone-based self-change modules help stabilize early natural recovery in problem drinkers. J Stud Alcohol Drugs. 2013;74(6):902–908. doi: 10.15288/jsad.2013.74.902.
    1. Hasin DS, Aharonovich E, Greenstein E. HealthCall for the smartphone: technology enhancement of brief intervention in HIV alcohol dependent patients. Addict Sci Clin Pract. 2014;9(1):5. doi: 10.1186/1940-0640-9-5.
    1. Rose GL, Skelly JM, Badger GJ, Ferraro TA, Helzer JE. Efficacy of automated telephone continuing care following outpatient therapy for alcohol dependence. Addict Behav. 2015;41:223–231. doi: 10.1016/j.addbeh.2014.10.022.
    1. Cooney NL, Litt MD, Sevarino KA, Levy L, Kranitz LS, Sackler H, Cooney JL. Concurrent alcohol and tobacco treatment: effect on daily process measures of alcohol relapse risk. J Consult Clin Psychol. 2015;83(2):346–358. doi: 10.1037/a0038633.
    1. Andersson C. Comparison of WEB and interactive voice response (IVR) methods for delivering brief alcohol interventions to hazardous-drinking university students: a randomized controlled trial. Eur Addict Res. 2015;21(5):240–252. doi: 10.1159/000381017.
    1. Andersson C, Öjehagen A, Olsson MO, Brådvik L, Håkansson A. Interactive voice response with feedback intervention in outpatient treatment of substance use problems in adolescents and young adults: a randomized controlled trial. Int J Behav Med. 2016;24(5):789–797. doi: 10.1007/s12529-016-9625-0.
    1. Andersson C, Vasiljevic Z, Höglund P, Öjehagen A, Berglund M. Daily automated telephone assessment and intervention improved 1-month outcome in paroled offenders. Int J Offender Ther Comp Criminol. 2014
    1. Rose GL, Badger GJ, Skelly JM, MacLean CD, Ferraro TA, Helzer JE. A randomized controlled trial of brief intervention by interactive voice response. Alcohol Alcohol. 2017;52(3):335–343.
    1. Sinadinovic K, Wennberg P, Johansson M, Berman AH. Targeting individuals with problematic alcohol use via Internet-based cognitive-behavioral self-help modules, personalized screening feedback or assessment only: a randomized controlled trial. Eur Addict Res. 2014;20:305–318. doi: 10.1159/000362406.
    1. Berman AH, Farzanfar R, Kristiansson M, Carlbring P, Friedman RH. Design and development of an interactive voice response (IVR) system to reduce impulsivity among violent forensic outpatients and probationers. J Med Syst. 2010
    1. Ahacic K, Nederfeldt L, Helgason ÁR. The national alcohol helpline in Sweden: an evaluation of its first year. Subst Abuse Treat Prev Policy. 2014;9(1):28. doi: 10.1186/1747-597X-9-28.
    1. Bergman H, Källmén H. Alcohol use among Swedes and a psychometric evaluation of the alcohol use disorders identification test. Alcohol Alcohol. 2002;37:245–251. doi: 10.1093/alcalc/37.3.245.
    1. Åhlin J, Hallgren M, Öjehagen A, Källmén H, Forsell Y. Adults with mild to moderate depression exhibit more alcohol related problems compared to the general adult population: a cross sectional study. BMC Public Health. 2015;15(1):542. doi: 10.1186/s12889-015-1837-8.
    1. Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT the alcohol use disorders identification test: guidelines for use in primary care. 2. Geneva: World Health Organization; 2001.
    1. Allebeck P, Espman E, Andreasson S. Swedish guidelines for low-risk alcohol drinking is needed. An expert group could create consensus and good impact. Lakartidningen. 2013;110(4):138–139.
    1. Vickers AJ, Altman DG. Analysing controlled trials with baseline and follow up measurements. BMJ. 2001;323(7321):1123–1124. doi: 10.1136/bmj.323.7321.1123.
    1. Sundström C, Kraepelien M, Eék N, Fahlke C, Kaldo V, Berman AH. High-intensity therapist-guided internet-based cognitive behavior therapy for alcohol use disorder: a pilot study. BMC Psychiatry. 2017;17(1):197. doi: 10.1186/s12888-017-1355-6.
    1. Gajecki M, Andersson C, Rosendahl I, Sinadinovic K, Fredriksson M, Berman AH. Skills training via smartphone app for university students with excessive alcohol consumption: a randomized controlled trial. Int J Behav Med. 2017;24(5):778–788. doi: 10.1007/s12529-016-9629-9.
    1. Gajecki M, Berman AH, Sinadinovic K, Rosendahl I, Andersson C. Mobile phone brief intervention applications for risky alcohol use among university students: a randomized controlled study. Addict Sci Clin Pract. 2014;9(1):11. doi: 10.1186/1940-0640-9-11.
    1. Berman AH, Gajecki M, Fredriksson M, Sinadinovic K, Andersson C. Smartphone applications for university students with hazardous alcohol use: study protocol for two consecutive randomized controlled trials. JMIR Res Protoc. 2015;4(4):e139. doi: 10.2196/resprot.4894.

Source: PubMed

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