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交互式语音应答简短干预的随机对照试验

A Randomized Controlled Trial of Brief Intervention by Interactive Voice Response.

作者信息

Rose Gail L, Badger Gary J, Skelly Joan M, MacLean Charles D, Ferraro Tonya A, Helzer John E

机构信息

Department of Psychiatry, The University of Vermont, USA.

Department of Medical Biostatistics, The University of Vermont, 27 Hills Building, Burlington, VT 05405, USA.

出版信息

Alcohol Alcohol. 2017 May 1;52(3):335-343. doi: 10.1093/alcalc/agw102.

Abstract

AIMS

To determine the effect of an Interactive Voice Response (IVR) brief intervention (BI) to reduce alcohol consumption among adults seeking primary care.

METHODS

Patients (N = 1855) with unhealthy drinking were recruited from eight academic internal medicine and family medicine clinics and randomized to IVR-BI (n = 938) versus No IVR-BI control (n = 917). Daily alcohol consumption was assessed at baseline, 3- and 6-months using the Timeline Followback.

RESULTS

The IVR-BI was completed by 95% of the 938 patients randomized to that condition, and 62% of them indicated a willingness to consider a change in their drinking. Participants in both conditions significantly reduced consumption over time, but changes were not different between groups. Regardless of condition, participants with alcohol use disorder (AUD) showed significant decreases in drinking outcomes. No significant changes were observed in patients without AUD, regardless of condition.

CONCLUSION

Although the IVR intervention was well accepted by patients, there was no evidence that IVR-BI was superior to No IVR-BI for reducing drinking in the subsequent 6 months. Because both the design and the intervention tested were novel, we cannot say definitively why this particular eHealth treatment lacked efficacy. It could be useful to evaluate the effect of the pre-randomization assessment alone on change in drinking. The high treatment engagement rate and successful implementation protocol are strengths, and can be adopted for future trials.

SHORT SUMMARY

We examined the efficacy of a novel BI for patient self-administration by automated telephone. Alcohol consumption decreased over time but there were no between-group changes in consumption. Regardless of treatment condition, participants with alcohol use disorder (AUD) showed significant reduction in drinking but participants without AUD showed no change.

摘要

目的

确定交互式语音应答(IVR)简短干预(BI)对减少寻求初级保健的成年人饮酒量的影响。

方法

从不健康饮酒的患者中招募了1855名患者,这些患者来自8个学术内科和家庭医学诊所,并随机分为IVR-BI组(n = 938)和无IVR-BI对照组(n = 917)。使用时间线追溯法在基线、3个月和6个月时评估每日饮酒量。

结果

随机分配到该组的938名患者中有95%完成了IVR-BI,其中62%表示愿意考虑改变饮酒习惯。两组患者的饮酒量均随时间显著减少,但两组之间的变化没有差异。无论处于何种情况,患有酒精使用障碍(AUD)的参与者饮酒量均显著下降。无论处于何种情况,无AUD的患者均未观察到显著变化。

结论

尽管IVR干预受到患者的广泛接受,但没有证据表明IVR-BI在随后6个月内减少饮酒方面优于无IVR-BI。由于所测试的设计和干预都是新颖的,我们无法确切说明为什么这种特定的电子健康治疗缺乏疗效。评估随机分组前评估对饮酒变化的单独影响可能会有所帮助。高治疗参与率和成功的实施方案是优势,可以应用于未来的试验。

简短总结

我们研究了一种新型的通过自动电话进行患者自我管理的简短干预的疗效。饮酒量随时间下降,但两组之间的饮酒量没有变化。无论治疗情况如何,患有酒精使用障碍(AUD)的参与者饮酒量显著减少,但无AUD的参与者没有变化。

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