Internet-based interventions curb problem drinking

Reference

Riper H, Hoogendoorn A, Cuijpers P, et al. Effectiveness and treatment moderators of internet interventions for adult problem drinking: An individual patient data meta-analysis of 19 randomised controlled trials. PLoS Med 2018;15(12):e1002714.

Synopsis

These authors systematically searched 7 medical and psychological databases to identify randomized trials of internet-based interventions that included people older than 18 years who were "problem drinkers." Problem drinkers are those whose volume and frequency of consumption potentially or currently pose a health risk (this is distinctly different from having an alcohol use disorder). Generally, problem drinking is quantified as 5 or more drinks in a single sitting or more than 14 in a week for men younger than 65 years, and for men older than 65 and for women, it is defined as 4 or more drinks in a single sitting or 8 or more in a week. The authors identified 19 relevant studies and obtained the data on 14,198 participants for analysis. Most studies lasted just a few months and only one evaluated participants after one year. The primary outcome was mean weekly alcohol consumption, using a standard unit of 10 grams of ethanol (but note: in the United States, a standard drink is 14 grams). Eighty percent of the participants consumed alcohol on a regular basis and 20% binge drank. Unfortunately, the authors only had follow-up data on 8095 participants—a significant threat to the validity of the data. Among completers, the internet-based interventions resulted in a net decrease of 5 drinks per week compared with control patients. Among women, alcohol consumption decreased 2 drinks per week. If we define treatment response as getting problem drinkers below the aforementioned thresholds, we would only need to treat 5 problem drinkers (95% CI 4 - 7) for one of them to no longer carry that label.