Web-based self-help reduces alcohol misuse
Internet-based self-help resources are effective in reducing alcohol misuse, a study from the Netherlands has shown.
The study found that those using a web-based self-help intervention were significantly more likely to achieve recommended drinking levels and reduce overall alcohol consumption than those in a control group.
The randomised controlled trial focused on drinkers in the general population rather than in clinical settings.
A total of 261 participants were recruited, who were aged between 18 and 65 years and whose drinking exceeded Dutch recommendations: an average of more than 21 units per week (14 for women) or at least six units (four for women) on at least one day per week over the previous three months. Participants who were receiving professional help for their drinking were excluded. The mean weekly alcohol intake of participants was 43.6 units.
The treatment group received access to a web-based self-help intervention based on cognitive behaviour and self-control principles, with a recommended treatment period of six weeks. The control group were directed to a website that gave only brief factual information on the effects and dangers of alcohol use.
Both the treatment and control groups showed a high loss to follow-up at six months (42%). For those who completed follow-up, both groups showed a reduction in drinking levels. However, those in the treatment group were significantly more likely
to have reduced their drinking to safe limits (success rates of 18.5% and 4.9% respectively, P=0.008), and had a significantly greater overall reduction in alcohol consumption than the control group (mean weekly intake 28.7 units and 39.2 units respectively, P=0.001).
Alcohol misuse is common and associated with high levels of morbidity and criminal justice costs. However, many alcohol misusers do not engage with primary care services. Web-based self-help interventions have been shown to be effective in helping hazardous drinkers reduce alcohol consumption and achieve safe levels of alcohol intake over a six-month period. GPs should support the development of similar initiatives in the UK.
Riper H, Kramer J, Smit F et al. Web-based self-help for problem drinkers: a pragmatic randomized trial. Addiction 2008;103:218-227Reviewer
Dr Jez Thompson
Former GP, Clinical Director, Leeds Community Drug Services