Riper Heleen, van Straten Annemieke, Keuken Max, Smit Filip, Schippers Gerard, Cuijpers Pim
Innovation Centre of Mental Health and Technology, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands.
Am J Prev Med. 2009 Mar;36(3):247-55. doi: 10.1016/j.amepre.2008.10.016.
The effectiveness of personalized-feedback interventions to reduce problem drinking has been evaluated in several RCTs and systematic reviews. A meta-analysis was performed to examine the overall effectiveness of brief, single-session personalized-feedback interventions without therapeutic guidance.
The selection and analyses of studies were conducted in 2008. Fourteen RCTs of single-session personalized-feedback interventions without therapeutic guidance were identified, and their combined effectiveness on the reduction of problematic alcohol consumption was evaluated in a meta-analysis. Alcohol consumption was the primary outcome measure.
The pooled standardized-effect size (14 studies, 15 comparisons) for reduced alcohol consumption at post-intervention was d=0.22 (95% CI=0.16, 0.29; the number needed to treat=8.06; areas under the curve=0.562). No heterogeneity existed among the studies (Q=10.962; p=0.69; I(2)=0).
The use of single-session personalized-feedback interventions without therapeutic guidance appears to be a viable and probably cost-effective option for reducing problem drinking in student and general populations. The Internet offers ample opportunities to deliver personalized-feedback interventions on a broad scale, and problem drinkers are known to be amenable to Internet-based interventions. More research is needed on the long-term effectiveness of personalized-feedback interventions for problem drinking, on its potential as a first step in a stepped-care approach, and on its effectiveness with other groups (such as youth obliged to use judicial service programs because of violations of minimum-age drinking laws) and in other settings (such as primary care).
在多项随机对照试验(RCT)和系统评价中,已对减少问题饮酒的个性化反馈干预措施的有效性进行了评估。开展了一项荟萃分析,以检验无治疗指导的简短单节次个性化反馈干预措施的总体有效性。
2008年进行了研究的筛选和分析。确定了14项无治疗指导的单节次个性化反馈干预措施的随机对照试验,并在一项荟萃分析中评估了它们对减少酒精问题消费的综合有效性。酒精消费是主要结局指标。
干预后减少酒精消费的合并标准化效应量(14项研究,15项比较)为d = 0.22(95%CI = 0.16,0.29;需治疗人数 = 8.06;曲线下面积 = 0.562)。各研究间不存在异质性(Q = 10.962;p = 0.69;I² = 0)。
使用无治疗指导的单节次个性化反馈干预措施似乎是减少学生和普通人群问题饮酒的一种可行且可能具有成本效益的选择。互联网为大规模提供个性化反馈干预措施提供了充足机会,而且已知问题饮酒者愿意接受基于互联网的干预措施。对于问题饮酒的个性化反馈干预措施的长期有效性、其作为阶梯式照护方法第一步的潜力、其在其他群体(如因违反最低饮酒年龄法律而必须使用司法服务项目的年轻人)和其他环境(如初级保健)中的有效性,还需要更多研究。