Web-based self-help for problem drinkers: pragmatic randomised trial.

H. Riper, J. Kramer, H.F.E. Smit, B. Conijn, G. Schippers, P. Cuijpers

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

ABSTRACT
Aims Self-help interventions for adult problem drinkers in the general population have proved effective. The question
is whether this also holds for self-help interventions delivered over the internet. Design We conducted a pragmatic
randomized trial with two parallel groups, using block randomization stratified for gender and with follow-up at
6 months. Setting The intervention and trial were conducted online in the Netherlands in 2003–2004.
Participants We selected 261 adult problem drinkers from the general population with aweekly alcohol consumption
above 210 g of ethanol for men or 140 g for women, or consuming at least 60 g (men) or 40 g (women) at least 1 day
aweek over the past 3 months. Participantswere randomized to either the experimental drinking less (DL) condition or
to the control condition (PBA). Intervention DL is a web-based, multi-component, interactive self-help intervention
for problem drinkers without therapist guidance. The recommended treatment period is 6 weeks. The intervention is
based on cognitive–behavioural and self-control principles. The control group received access to an online psychoeducational
brochure on alcohol use (PBA). Outcome measures We assessed the following outcome measures at
6-month follow-up: (i) the percentage of participants who had reduced their drinking levels to within the normative
limits of the Dutch guideline for low-risk drinking; and (ii) the reduction in mean weekly alcohol consumption.
Findings At follow-up, 17.2% of the intervention group participants had reduced their drinking successfully to
within the guideline norms; in the control group this was 5.4% [odds ratio (OR) = 3.66; 95% confidence interval (CI)
1.3–10.8; P = 0.006; number needed to treat (NNT) = 8.5]. The intervention subjects decreased their mean weekly
alcohol consumption significantly more than control subjects, with a difference of 12.0 standardized units (95% CI
5.9–18.1; P < 0.001; standardized mean difference 0.40). Conclusions To our knowledge this is one of the first
randomized controlled trials on aweb-based self-help intervention without therapist guidance for self-referred problem
drinkers among the adult general population. The intervention showed itself to be effective in reducing problem
drinking in the community.
Keywords General population, internet, pragmatic randomized controlled trial, problem drinking, self-help.
Original languageEnglish
Pages (from-to)218-227
Number of pages10
JournalAddiction
Volume103
DOIs
Publication statusPublished - 2008

Fingerprint

Pragmatic Clinical Trials
Drinking
Internet
Population
Alcohols
Outcome Assessment (Health Care)
Guidelines
Numbers Needed To Treat
Control Groups
Random Allocation
Alcohol Drinking
Netherlands
Ethanol
Randomized Controlled Trials
Odds Ratio
Confidence Intervals

Cite this

Riper, H. ; Kramer, J. ; Smit, H.F.E. ; Conijn, B. ; Schippers, G. ; Cuijpers, P. / Web-based self-help for problem drinkers: pragmatic randomised trial. In: Addiction. 2008 ; Vol. 103. pp. 218-227.
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abstract = "ABSTRACTAims Self-help interventions for adult problem drinkers in the general population have proved effective. The questionis whether this also holds for self-help interventions delivered over the internet. Design We conducted a pragmaticrandomized trial with two parallel groups, using block randomization stratified for gender and with follow-up at6 months. Setting The intervention and trial were conducted online in the Netherlands in 2003–2004.Participants We selected 261 adult problem drinkers from the general population with aweekly alcohol consumptionabove 210 g of ethanol for men or 140 g for women, or consuming at least 60 g (men) or 40 g (women) at least 1 dayaweek over the past 3 months. Participantswere randomized to either the experimental drinking less (DL) condition orto the control condition (PBA). Intervention DL is a web-based, multi-component, interactive self-help interventionfor problem drinkers without therapist guidance. The recommended treatment period is 6 weeks. The intervention isbased on cognitive–behavioural and self-control principles. The control group received access to an online psychoeducationalbrochure on alcohol use (PBA). Outcome measures We assessed the following outcome measures at6-month follow-up: (i) the percentage of participants who had reduced their drinking levels to within the normativelimits of the Dutch guideline for low-risk drinking; and (ii) the reduction in mean weekly alcohol consumption.Findings At follow-up, 17.2{\%} of the intervention group participants had reduced their drinking successfully towithin the guideline norms; in the control group this was 5.4{\%} [odds ratio (OR) = 3.66; 95{\%} confidence interval (CI)1.3–10.8; P = 0.006; number needed to treat (NNT) = 8.5]. The intervention subjects decreased their mean weeklyalcohol consumption significantly more than control subjects, with a difference of 12.0 standardized units (95{\%} CI5.9–18.1; P < 0.001; standardized mean difference 0.40). Conclusions To our knowledge this is one of the firstrandomized controlled trials on aweb-based self-help intervention without therapist guidance for self-referred problemdrinkers among the adult general population. The intervention showed itself to be effective in reducing problemdrinking in the community.Keywords General population, internet, pragmatic randomized controlled trial, problem drinking, self-help.",
author = "H. Riper and J. Kramer and H.F.E. Smit and B. Conijn and G. Schippers and P. Cuijpers",
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Web-based self-help for problem drinkers: pragmatic randomised trial. / Riper, H.; Kramer, J.; Smit, H.F.E.; Conijn, B.; Schippers, G.; Cuijpers, P.

In: Addiction, Vol. 103, 2008, p. 218-227.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Web-based self-help for problem drinkers: pragmatic randomised trial.

AU - Riper, H.

AU - Kramer, J.

AU - Smit, H.F.E.

AU - Conijn, B.

AU - Schippers, G.

AU - Cuijpers, P.

PY - 2008

Y1 - 2008

N2 - ABSTRACTAims Self-help interventions for adult problem drinkers in the general population have proved effective. The questionis whether this also holds for self-help interventions delivered over the internet. Design We conducted a pragmaticrandomized trial with two parallel groups, using block randomization stratified for gender and with follow-up at6 months. Setting The intervention and trial were conducted online in the Netherlands in 2003–2004.Participants We selected 261 adult problem drinkers from the general population with aweekly alcohol consumptionabove 210 g of ethanol for men or 140 g for women, or consuming at least 60 g (men) or 40 g (women) at least 1 dayaweek over the past 3 months. Participantswere randomized to either the experimental drinking less (DL) condition orto the control condition (PBA). Intervention DL is a web-based, multi-component, interactive self-help interventionfor problem drinkers without therapist guidance. The recommended treatment period is 6 weeks. The intervention isbased on cognitive–behavioural and self-control principles. The control group received access to an online psychoeducationalbrochure on alcohol use (PBA). Outcome measures We assessed the following outcome measures at6-month follow-up: (i) the percentage of participants who had reduced their drinking levels to within the normativelimits of the Dutch guideline for low-risk drinking; and (ii) the reduction in mean weekly alcohol consumption.Findings At follow-up, 17.2% of the intervention group participants had reduced their drinking successfully towithin the guideline norms; in the control group this was 5.4% [odds ratio (OR) = 3.66; 95% confidence interval (CI)1.3–10.8; P = 0.006; number needed to treat (NNT) = 8.5]. The intervention subjects decreased their mean weeklyalcohol consumption significantly more than control subjects, with a difference of 12.0 standardized units (95% CI5.9–18.1; P < 0.001; standardized mean difference 0.40). Conclusions To our knowledge this is one of the firstrandomized controlled trials on aweb-based self-help intervention without therapist guidance for self-referred problemdrinkers among the adult general population. The intervention showed itself to be effective in reducing problemdrinking in the community.Keywords General population, internet, pragmatic randomized controlled trial, problem drinking, self-help.

AB - ABSTRACTAims Self-help interventions for adult problem drinkers in the general population have proved effective. The questionis whether this also holds for self-help interventions delivered over the internet. Design We conducted a pragmaticrandomized trial with two parallel groups, using block randomization stratified for gender and with follow-up at6 months. Setting The intervention and trial were conducted online in the Netherlands in 2003–2004.Participants We selected 261 adult problem drinkers from the general population with aweekly alcohol consumptionabove 210 g of ethanol for men or 140 g for women, or consuming at least 60 g (men) or 40 g (women) at least 1 dayaweek over the past 3 months. Participantswere randomized to either the experimental drinking less (DL) condition orto the control condition (PBA). Intervention DL is a web-based, multi-component, interactive self-help interventionfor problem drinkers without therapist guidance. The recommended treatment period is 6 weeks. The intervention isbased on cognitive–behavioural and self-control principles. The control group received access to an online psychoeducationalbrochure on alcohol use (PBA). Outcome measures We assessed the following outcome measures at6-month follow-up: (i) the percentage of participants who had reduced their drinking levels to within the normativelimits of the Dutch guideline for low-risk drinking; and (ii) the reduction in mean weekly alcohol consumption.Findings At follow-up, 17.2% of the intervention group participants had reduced their drinking successfully towithin the guideline norms; in the control group this was 5.4% [odds ratio (OR) = 3.66; 95% confidence interval (CI)1.3–10.8; P = 0.006; number needed to treat (NNT) = 8.5]. The intervention subjects decreased their mean weeklyalcohol consumption significantly more than control subjects, with a difference of 12.0 standardized units (95% CI5.9–18.1; P < 0.001; standardized mean difference 0.40). Conclusions To our knowledge this is one of the firstrandomized controlled trials on aweb-based self-help intervention without therapist guidance for self-referred problemdrinkers among the adult general population. The intervention showed itself to be effective in reducing problemdrinking in the community.Keywords General population, internet, pragmatic randomized controlled trial, problem drinking, self-help.

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DO - 10.1111/j.1360-0443.2007.02063.x

M3 - Article

VL - 103

SP - 218

EP - 227

JO - Addiction

JF - Addiction

SN - 0965-2140

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