Brief, cognitive-behavioral intervention to promote treatment seeking in adults with severe alcohol use disorder: A randomized controlled trial

IF 5.2 1区医学 Q1 PSYCHIATRY Addiction Pub Date : 2023-07-24 DOI:10.1111/add.16300

Kenneth R. Conner, Stephen A. Maisto, Beau Abar, Sarah Szafranski, Andrew Chiang, Morica Hutchison, Aileen Aldalur, Tracy Stecker

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Abstract

Background and Aims

There is little RCT evidence that brief interventions improve treatment seeking in individuals with severe alcohol use disorder (AUD) or treatment seeking reduces alcohol use. The aim was to test the efficacy of a brief intervention to increase treatment seeking in treatment naïve adults with severe AUD and measure its effects on alcohol use.

Design

Parallel group, non-pharmacologic RCT with intervention (n = 197) and active control (n = 203) conditions, with blinded assessors conducting follow-ups at 1, 3 and 6 months.

Setting

Online recruitment in a 17-county region of upstate New York, USA.

Participants

Inclusion criteria consisted of ages ≥18 years, Alcohol Use Disorders Identification Test score ≥16, exceeds recommended limits for alcohol use and no history of AUD treatment. n = 400; 50% female; 79% white; mean age, 40.7; mean education, 14.6 years.

Intervention and comparator

One-session telephone-delivered interventions: Cognitive-Behavioral Therapy for Treatment Seeking (CBT-TS; intervention), review of a National Institute on Alcohol Abuse and Alcoholism pamphlet on AUD treatment (control).

Measurements

Self-report of any AUD treatment use over 3 months (primary outcome) and two standard measures of alcohol use over 6 months (secondary outcomes).

Findings

Intent-to-treat analyses were used. Assessment follow-up rates were ≥93%. Any alcohol-related treatment use over 3-month follow-up was obtained by 38 (19%) intervention participants and 36 (18%) control participants, a non-significant difference, χ² [1] = 0.16, P = 0.689. Secondary analysis showed a significant interaction term between sex and intervention assignment (β = −1.197, P = 0.027). The interaction suggested CBT-TS was effective in men (22% vs 13%), although the evidence was somewhat weak (P = 0.071), and it was not effective in women (17% vs 24%).

Conclusions

A one-session cognitive-behavioral therapy intervention to increase treatment seeking in treatment naïve adults with severe alcohol use disorder did not increase treatment seeking.

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简短的认知行为干预促进严重酒精使用障碍成年人寻求治疗：一项随机对照试验。

背景和目的：很少有随机对照试验证据表明，短期干预可以改善严重酒精使用障碍（AUD）患者的治疗寻求，或治疗寻求可以减少酒精使用。目的是测试一种简短干预措施的疗效，以增加对患有严重AUD的天真成年人的治疗寻求，并测量其对饮酒的影响。设计：平行组，非药物随机对照试验加干预（n = 197）和主动控制（n = 203）条件，盲法评估员在1、3和6个月时进行随访。设置：在美国纽约州北部17个县的地区进行在线招募。参与者：纳入标准包括年龄≥18岁年，酒精使用障碍识别测试得分≥16，超过酒精使用建议限值，且无AUD治疗史。n = 400；50%为女性；79%为白色；平均年龄40.7岁；平均受教育年限14.6年。干预和比较：一次电话干预：寻求治疗的认知行为疗法（CBT-TS；干预），国家酗酒和酗酒研究所关于AUD治疗（对照）的小册子综述。测量：3个月以上任何AUD治疗使用的自我报告（主要结果）和6个月以上饮酒的两项标准测量（次要结果）。结果：使用意向治疗分析。评估随访率≥93%。38名（19%）干预参与者和36名（18%）对照参与者在3个月的随访中获得了任何与酒精相关的治疗使用情况，差异无统计学意义，χ2[1] = 0.16，P = 0.689。二次分析显示，性别和干预分配之间存在显著的交互作用项（β = -1.197，P = 0.027）。相互作用表明CBT-TS对男性有效（22%对13%），尽管证据有些薄弱（P = 0.071），对女性无效（17%对24%）。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.