Wongpakaran Tinakon, Petcharaj Kachanun, Wongpakaran Nahathai, Sombatmai Sangworn, Boripuntakul Theerarat, Intarakamhaeng Danai, Wannarit Kamonporn
Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Med Assoc Thai. 2011 Jul;94(7):849-56.
The present study was to examine the efficacy of Telephone-based intervention (TBI) with alcohol abusers.
Sixty individuals suffering from alcohol abuse were randomly assigned to either the intervention group (n=30) (in which the TBI was modified based on the combination of motivational interviewing and supportive techniques), or the control group (n=30) (in which the participants received mail concerning health promotion). Each participant in the intervention group received individual weekly therapy sessions of 20 to 30 minutes via telephone for six weeks. Simultaneously, the participants in the control group received weekly mails for six weeks. Assessment was done at weeks 0, 6, and 18. The primary outcome was defined as a change in the amount of alcohol consumed and the number ofdays spent drinking. Anxiety, depression, and self-esteem were also compared between the two groups. All were analyzed by intention-to-treat.
After 18 weeks, 54 out of the original 60 participants had complete data sets. The mean amount and frequency of alcohol consumption was significantly lower in the intervention group than in the control group (4.1 days +/- 2.0 vs. 2.8 days +/- 2.0, p < 0.01). At the end of week six, 37.3% of participants in the experiment group (compared with 11.8% of the control) had successfully decreased their alcohol consumption (f = 16.49, df = I, p < 0.001, with an NNT = 1.69). The frequency of drinking, as determined by the number of drinking days per week, was significantly lower in the experiment group from baseline than in the control group at week 6 (2 = 18.20, df= 1, p < 0.001, with an NNT = 1.8). There was no difference between week 6 and the end of week 18 regarding amount and frequency of drinking in both groups. There was no difference in depressive, anxiety and self-esteem scores between the two groups over time and these factors were found to have no effect on alcohol consumption in either group. A common problem reported in the telephone group was connection failures.
Telephone motivational interviews showed promise in being effective in reducing the frequency and amount of drinking for non-treatment-seeking primary care patients who abuse alcohol. Moreover, the effect of the intervention lasted for at least three months. Limitations of the present study are discussed.
本研究旨在检验基于电话的干预措施(TBI)对酗酒者的疗效。
60名酗酒者被随机分为干预组(n = 30)(在该组中,TBI基于动机访谈和支持性技巧的结合进行了调整)和对照组(n = 30)(该组参与者收到有关健康促进的邮件)。干预组的每位参与者通过电话接受为期六周、每周一次、每次20至30分钟的个体治疗。同时,对照组的参与者连续六周每周收到邮件。在第0、6和18周进行评估。主要结局定义为饮酒量和饮酒天数的变化。还对两组之间的焦虑、抑郁和自尊进行了比较。所有分析均采用意向性分析。
18周后,最初的60名参与者中有54人拥有完整的数据集。干预组的平均饮酒量和饮酒频率显著低于对照组(4.1天±2.0天 vs. 2.8天±2.0天,p < 0.01)。在第六周结束时,实验组37.3%的参与者(对照组为11.8%)成功减少了饮酒量(f = 16.49,自由度 = 1,p < 0.001,需治人数 = 1.69)。根据每周饮酒天数确定的饮酒频率,实验组在第6周时较基线显著低于对照组(z = 18.20,自由度 = 1,p < 0.001,需治人数 = 1.8)。两组在第6周和第18周结束时的饮酒量和饮酒频率没有差异。两组之间抑郁、焦虑和自尊得分随时间没有差异,且发现这些因素对两组中的饮酒行为均无影响。电话组报告的一个常见问题是连接失败。
电话动机访谈对于减少酗酒的非寻求治疗的初级保健患者的饮酒频率和饮酒量显示出有效前景。此外,干预效果至少持续三个月。本文讨论了本研究的局限性。