{"title":"针对问题性饮酒的前瞻性视频疗法对治疗启动、依从性和酒精摄入量的效果：丹麦的随机对照试验","authors":"Kia Kejlskov Egan MSc , Prof Ulrik Becker DMSc , Sanne Pagh M⊘ller MSc , Veronica Pisinger PhD , Prof Janne Schurmann Tolstrup PhD","doi":"10.1016/S2589-7500(24)00067-0","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Few people with problematic alcohol use reach treatment and dropout is frequent. Therapy for problematic alcohol use delivered via video conference (e-alcohol therapy) might overcome treatment barriers. In this randomised study, we tested whether proactive e-alcohol therapy outperformed face-to-face alcohol therapy (standard care) regarding treatment initiation, compliance, and weekly alcohol intake at 3-month and 12-month follow-up.</p></div><div><h3>Methods</h3><p>In this two-arm randomised controlled trial, we recruited individuals who had problematic alcohol use, defined as a score of 8 or more on the Alcohol Use Disorders Identification Test; were 18 years or older; and had access to a personal computer, smartphone, or tablet with internet access in Denmark through online advertisements. Participants were assigned to receive alcohol therapy delivered either face-to-face or via video conference. The number, frequency, and duration of therapy sessions were individualised in both groups. Data analysis was conducted using masked data. Primary analyses were based on an intention-to-treat sample. The study is registered with <span>ClinicalTrials.gov</span><svg><path></path></svg> (<span>NCT03116282</span><svg><path></path></svg>).</p></div><div><h3>Findings</h3><p>Between Jan 22, 2018, and June 29, 2020, 816 individuals signed up for the trial and 502 (63%) were assessed for eligibility. We randomly assigned 379 to proactive e-alcohol therapy (n=187) or standard care (n=192), of which, 170 (48%) participants were female and 186 (52%) were male. In the intervention group, more participants initiated treatment (155 [88%] of 177 <em>vs</em> 96 [54%] of 179; odds ratio [OR] 6·3; 95% CI 2·8 to 13·8; p<0·0001 at 3 months; 151 [85%] of 177 <em>vs</em> 115 [64%] of 179; OR 3·2; 95% CI 1·6 to 6·2; p=0·0007 at 12 months) and complied with treatment (130 [73%] of 177 <em>vs</em> 74 [41%] of 179; OR 4·0; 95% CI 2·2 to 7·2; p<0·0001 at 3 months; 140 [79%] of 177 <em>vs</em> 95 [53%] of 179; OR 3·4; 95% CI 1·8 to 6·3; p=0·0002 at 12 months). Weekly alcohol intake was significantly lower in the intervention group only after 3 months (13·0 standard drinks per week <em>vs</em> 21·3 standard drinks per week; adjusted difference –6·7; 95% CI –12·3 to –1·0; p=0·019).</p></div><div><h3>Interpretation</h3><p>Proactive e-alcohol therapy was associated with increased treatment initiation and compliance and is promising as an easily accessible and effective alcohol treatment for individuals with problematic alcohol use.</p></div><div><h3>Funding</h3><p>TrygFonden.</p></div>","PeriodicalId":48534,"journal":{"name":"Lancet Digital Health","volume":"6 6","pages":"Pages e418-e427"},"PeriodicalIF":23.8000,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589750024000670/pdfft?md5=6791fc7fb00477e6d6469dc31f400771&pid=1-s2.0-S2589750024000670-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of proactive video therapy for problematic alcohol use on treatment initiation, compliance, and alcohol intake: a randomised controlled trial in Denmark\",\"authors\":\"Kia Kejlskov Egan MSc , Prof Ulrik Becker DMSc , Sanne Pagh M⊘ller MSc , Veronica Pisinger PhD , Prof Janne Schurmann Tolstrup PhD\",\"doi\":\"10.1016/S2589-7500(24)00067-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Few people with problematic alcohol use reach treatment and dropout is frequent. Therapy for problematic alcohol use delivered via video conference (e-alcohol therapy) might overcome treatment barriers. In this randomised study, we tested whether proactive e-alcohol therapy outperformed face-to-face alcohol therapy (standard care) regarding treatment initiation, compliance, and weekly alcohol intake at 3-month and 12-month follow-up.</p></div><div><h3>Methods</h3><p>In this two-arm randomised controlled trial, we recruited individuals who had problematic alcohol use, defined as a score of 8 or more on the Alcohol Use Disorders Identification Test; were 18 years or older; and had access to a personal computer, smartphone, or tablet with internet access in Denmark through online advertisements. Participants were assigned to receive alcohol therapy delivered either face-to-face or via video conference. The number, frequency, and duration of therapy sessions were individualised in both groups. Data analysis was conducted using masked data. 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引用次数: 0
摘要
背景有酗酒问题的人很少接受治疗，而且经常辍学。通过视频会议（电子酒精疗法）对问题性饮酒进行治疗可能会克服治疗障碍。在这项随机研究中，我们测试了在 3 个月和 12 个月的随访中，积极主动的电子酒精疗法在治疗启动、依从性和每周酒精摄入量方面是否优于面对面酒精疗法（标准护理）。方法在这项双臂随机对照试验中，我们通过在线广告招募了有问题酒精使用的个人，其定义是酒精使用障碍识别测试中的得分达到或超过 8 分；年龄在 18 岁或以上；在丹麦可以使用个人电脑、智能手机或平板电脑上网。参与者被分配接受面对面或通过视频会议提供的酒精治疗。两组的治疗次数、频率和持续时间都是个性化的。数据分析采用蒙面数据。主要分析基于意向治疗样本。该研究已在ClinicalTrials.gov（NCT03116282）上注册。研究结果在2018年1月22日至2020年6月29日期间，共有816人报名参加试验，其中502人（63%）通过了资格评估。我们随机分配了379人接受主动电子酒精疗法（187人）或标准护理（192人），其中170人（48%）为女性，186人（52%）为男性。在干预组中，更多参与者开始接受治疗（177 人中的 155 [88%] 对 179 人中的 96 [54%]；3 个月时的几率比 [OR] 6-3；95% CI 2-8 到 13-8；p<0-0001；177 人中的 151 [85%] 对 179 人中的 115 [64%]；OR 3-2；95% CI 1-6 到 6-2；12个月时，p=0-0007）和坚持治疗（177人中有130人[73%] vs 179人中有74人[41%]；3个月时，OR 4-0；95% CI 2-2 to 7-2；p<0-0001；177人中有140人[79%] vs 179人中有95人[53%]；12个月时，OR 3-4; 95% CI 1-8 to 6-3；p=0-0002）。只有在3个月后，干预组的每周酒精摄入量才明显降低（每周13-0标准饮品 vs 每周21-3标准饮品；调整后差异为-6-7；95% CI为-12-3至-1-0；p=0-019）。释义积极的电子酒精疗法与治疗启动率和依从性的提高有关，有望成为针对酗酒问题患者的一种方便有效的酒精治疗方法。
Effectiveness of proactive video therapy for problematic alcohol use on treatment initiation, compliance, and alcohol intake: a randomised controlled trial in Denmark
Background
Few people with problematic alcohol use reach treatment and dropout is frequent. Therapy for problematic alcohol use delivered via video conference (e-alcohol therapy) might overcome treatment barriers. In this randomised study, we tested whether proactive e-alcohol therapy outperformed face-to-face alcohol therapy (standard care) regarding treatment initiation, compliance, and weekly alcohol intake at 3-month and 12-month follow-up.
Methods
In this two-arm randomised controlled trial, we recruited individuals who had problematic alcohol use, defined as a score of 8 or more on the Alcohol Use Disorders Identification Test; were 18 years or older; and had access to a personal computer, smartphone, or tablet with internet access in Denmark through online advertisements. Participants were assigned to receive alcohol therapy delivered either face-to-face or via video conference. The number, frequency, and duration of therapy sessions were individualised in both groups. Data analysis was conducted using masked data. Primary analyses were based on an intention-to-treat sample. The study is registered with ClinicalTrials.gov (NCT03116282).
Findings
Between Jan 22, 2018, and June 29, 2020, 816 individuals signed up for the trial and 502 (63%) were assessed for eligibility. We randomly assigned 379 to proactive e-alcohol therapy (n=187) or standard care (n=192), of which, 170 (48%) participants were female and 186 (52%) were male. In the intervention group, more participants initiated treatment (155 [88%] of 177 vs 96 [54%] of 179; odds ratio [OR] 6·3; 95% CI 2·8 to 13·8; p<0·0001 at 3 months; 151 [85%] of 177 vs 115 [64%] of 179; OR 3·2; 95% CI 1·6 to 6·2; p=0·0007 at 12 months) and complied with treatment (130 [73%] of 177 vs 74 [41%] of 179; OR 4·0; 95% CI 2·2 to 7·2; p<0·0001 at 3 months; 140 [79%] of 177 vs 95 [53%] of 179; OR 3·4; 95% CI 1·8 to 6·3; p=0·0002 at 12 months). Weekly alcohol intake was significantly lower in the intervention group only after 3 months (13·0 standard drinks per week vs 21·3 standard drinks per week; adjusted difference –6·7; 95% CI –12·3 to –1·0; p=0·019).
Interpretation
Proactive e-alcohol therapy was associated with increased treatment initiation and compliance and is promising as an easily accessible and effective alcohol treatment for individuals with problematic alcohol use.
期刊介绍：
The Lancet Digital Health publishes important, innovative, and practice-changing research on any topic connected with digital technology in clinical medicine, public health, and global health.
The journal’s open access content crosses subject boundaries, building bridges between health professionals and researchers.By bringing together the most important advances in this multidisciplinary field,The Lancet Digital Health is the most prominent publishing venue in digital health.
We publish a range of content types including Articles,Review, Comment, and Correspondence, contributing to promoting digital technologies in health practice worldwide.
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