Effectiveness and treatment moderators of internet interventions for adult problem drinking: An individual patient data meta-analysis of 19 randomised controlled trials

Heleen Riper, Adriaan Hoogendoorn, Pim Cuijpers, Eirini Karyotaki, Nikolaos Boumparis, Adriana Mira, Gerhard Andersson, Anne H Berman, Nicolas Bertholet, Gallus Bischof, Matthijs Blankers, Brigitte Boon, Leif Boß, Håvar Brendryen, John Cunningham, David Ebert, Anders Hansen, Reid Hester, Zarnie Khadjesari, Jeannet Kramer, Elizabeth Murray, Marloes Postel, Daniela Schulz, Kristina Sinadinovic, Brian Suffoletto, Christopher Sundström, Hein de Vries, Paul Wallace, Reinout W Wiers and Johannes H Smit

PLOS Medicine, 2018, vol. 15, issue 12, 1-26

Abstract: Background: Face-to-face brief interventions for problem drinking are effective, but they have found limited implementation in routine care and the community. Internet-based interventions could overcome this treatment gap. We investigated effectiveness and moderators of treatment outcomes in internet-based interventions for adult problem drinking (iAIs). Methods and findings: Systematic searches were performed in medical and psychological databases to 31 December 2016. A one-stage individual patient data meta-analysis (IPDMA) was conducted with a linear mixed model complete-case approach, using baseline and first follow-up data. The primary outcome measure was mean weekly alcohol consumption in standard units (SUs, 10 grams of ethanol). Secondary outcome was treatment response (TR), defined as less than 14/21 SUs for women/men weekly. Putative participant, intervention, and study moderators were included. Robustness was verified in three sensitivity analyses: a two-stage IPDMA, a one-stage IPDMA using multiple imputation, and a missing-not-at-random (MNAR) analysis. We obtained baseline data for 14,198 adult participants (19 randomised controlled trials [RCTs], mean age 40.7 [SD = 13.2], 47.6% women). Their baseline mean weekly alcohol consumption was 38.1 SUs (SD = 26.9). Most were regular problem drinkers (80.1%, SUs 44.7, SD = 26.4) and 19.9% (SUs 11.9, SD = 4.1) were binge-only drinkers. About one third were heavy drinkers, meaning that women/men consumed, respectively, more than 35/50 SUs of alcohol at baseline (34.2%, SUs 65.9, SD = 27.1). Post-intervention data were available for 8,095 participants. Compared with controls, iAI participants showed a greater mean weekly decrease at follow-up of 5.02 SUs (95% CI −7.57 to −2.48, p

Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pmed00:1002714

DOI: 10.1371/journal.pmed.1002714

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