Eric A. Dedert, PhD
John W. Williams, MD, MHSc
Dedert EA, McDuffie JR, Stein R, McNiel JM, Kosinski AS, Freiermuth CE, Hemminger A,Williams JW Jr. Ann Intern Med. 4 August 2015, 163(3):205-214 doi:10.7326/M15-0285 [PubMed]
Congratulations to Dr. John Williams and his team for this publication in the Annals of Internal Medicine. These authors reflect expertise from the Evidence-based Synthesis Program Center (ESP) in the Durham VA where Dr. Williams is the director of the ESP and where many of our HSR&D researchers reside. The paper’s first author is Dr. Eric Dedert, who is supported by a career development award from CSR&D, and the senior author is Dr. Williams.
The authors reviewed clinical trials comparing an electronic intervention for alcohol misuse to inactive control groups, i.e., treatment as usual, and reported effects at least 6 months after randomization. Features that make this review stand out are:
- Most available electronic interventions for alcohol misuse are brief, with little or no human support to promote continued use of the intervention.
- In people receiving the electronic interventions There was evidence of reduced alcohol intake of an average of approximately 1 less drink per week, with diminishing effects at 12 months. This was true of both college students and non-college adults.
- However, relatively few trials reported on other clinically significant outcomes such as meeting drinking limit guidelines (defined above), number of binge drinking episodes, social consequences of drinking, and alcohol-related health problems. The available data provided insufficient evidence in support of a benefit of electronic interventions for these outcomes.
- There are only a few trials that have investigated electronic interventions for alcohol use disorders, which are a more severe form of alcohol misuse.
Here’s something also of note: in patients with alcohol use disorder (AUD) who were discharged from inpatient rehab, those randomized to a sophisticated mobile phone app intervention – meaning they had GPS tracking to warn away from bars, they received peer support, cognitive behavioral therapy, and reported back to their counselor – doubled the odds of abstinence at 12 months!
Learn more about Dr. Williams in this GIM faculty spotlight from June 2015.
