Here’s another promising finding for behavioral health in healthcare’s digital transformation.
In the popular TV show “Intervention,” many people suffering through addiction, from alcohol and opioids to methamphetamine and dust cleaner, have faced something almost none of them desired. After being led by a friend or loved one to an inconspicuous place, the show’s subject encountered friends and loved ones, with notes in hand and often in tears. Willing or not, the lead character had stumbled into an intervention, and it meant that something had to change.
But not every intervention is so public and painful. And not every intervention is that kind of intervention.
Take, for example, this new study on internet-based interventions for problem drinkers, which appears in the journal Plos Medicine. In this context, the intervention is not a well-attended plea for a family member to enter inpatient therapy, but rather a single- or multiple-session program in which a healthcare provider helps a problem drinker — not a patient with alcohol use disorders — cut down their hazardous drinking. Internet-based alcohol interventions function similarly but can be performed digitally, via email or another medium — and they appear to work, according to the study findings.
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“For many people, (internet-based alcohol interventions) could serve as a first step towards changing their problem-drinking behaviors and towards more intensive treatment, if needed,” wrote lead author Heleen Riper, Ph.D., professor of e-mental health at VU University Amsterdam, in the Netherlands, and her colleagues.
The researchers found that these digital interventions helped decrease mean weekly alcohol intake from 381 to 329 grams. Patients who took part in internet-based alcohol interventions were more likely than others to stick to low-risk drinking limits. And, perhaps most surprising, these results were true for heavy, regular and binge drinkers alike.
But digital interventions were more likely to stick with patients who were at least 55 years old, as they exhibited higher post-intervention adherence rates to low-risk drinking limits.
What’s more, men and less-educated people saw their mean weekly alcohol consumption drop by roughly 20 grams more than other participants, according to the study.
Although internet-based alcohol interventions can be totally automated, programs that operated with a human healthcare provider guide tended to result in better outcomes for patients, according to the findings. But that figure could have been inflated by the design of the study.
Overall, however, the findings may be welcome news for behavioral health providers, organizations and patients, especially those who faced healthcare access issues in the past.
“The health gains of internet-based alcohol interventions could be substantial because such programs can reach high numbers of problem drinkers by virtue of their swift entry procedures and their easy scalability,” Riper and her colleagues wrote.
To reach these results, researchers performed a one-stage individual patient data meta-analysis of 14,198 adults from 19 randomized controlled trials who had shown some sort of problematic drinking. Investigators had also acquired post-treatment data for almost 8,100 of these individuals.
Riper and her team noted that this was the first such analysis that suggested internet-based alcohol interventions are successful inside and outside the clinic.
So, what do these kinds of interventions look like?
They are similar to brief alcohol interventions, which often occur in primary care offices or the community, comprising no more than six sessions. The in-person interventions focus on personalized normative feedback, cognitive behavioral therapy, motivational interviewing, behavioral self-control principles and so on.
Internet-based alcohol interventions feature much of the same, but they typically take place via secure email. Sometimes, a computer program automates the process, prodding a patient to complete the program solo. Sometimes, a healthcare provider leads the intervention.
The internet-based tool could become especially powerful for primary care providers who want to help their patients overcome problem drinking, according to the study.
This, of course, is far from the first digital health undertaking to show promise in helping patients overcome a behavioral health issue. The internet and apps have even emerged as a potential weapon against substance abuse disorder.
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