Kraepelien Martin, Sundström Christopher, Johansson Magnus, Ivanova Ekaterina
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden; and Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden; and Department of Psychology, Stockholm University, Stockholm, Sweden.
BJPsych Open. 2023 May 24;9(3):e91. doi: 10.1192/bjo.2023.73.
Digital interventions based on cognitive-behavioural therapy and relapse prevention can increase treatment access for people with problematic alcohol use, but for these interventions to be cost-effective, clinician workload needs to remain low while ensuring patient adherence and effects. Digital psychological self-care is the provision of a self-guided digital intervention within a structured care process.
To investigate the feasibility and preliminary effects of digital psychological self-care for reducing alcohol consumption.
Thirty-six adults with problematic alcohol use received digital psychological self-care during 8 weeks, including telephone assessments as well as filling out self-rated questionnaires, before, directly after and 3 months after the intervention. Intervention adherence, usefulness, credibility and use of clinician time were assessed, along with preliminary effects on alcohol consumption. The study was prospectively registered as a clinical trial (NCT05037630).
Most participants used the intervention daily or several times a week. The digital intervention was regarded as credible and useful, and there were no reported adverse effects. Around 1 h of clinician time per participant was spent on telephone assessments. At the 3-month follow-up, preliminary within-group effects on alcohol consumption were moderate (standardised drinks per week, Hedge's = 0.70, 95% CI = 0.19-1.21; heavy drinking days, Hedge's = 0.60, 95% CI = 0.09-1.11), reflecting a decrease from 23 to 13 drinks per week on average.
Digital psychological self-care for reducing alcohol consumption appears both feasible and preliminarily effective and should be further optimised and studied in larger trials.
基于认知行为疗法和预防复发的数字干预措施可以增加有酒精使用问题的人群获得治疗的机会，但要使这些干预措施具有成本效益，临床医生的工作量需要保持在较低水平，同时要确保患者的依从性和治疗效果。数字心理自我护理是在结构化护理过程中提供自我引导的数字干预。
研究数字心理自我护理对减少酒精消费的可行性和初步效果。
36名有酒精使用问题的成年人在8周内接受了数字心理自我护理，包括在干预前、干预刚结束时和干预后3个月进行电话评估以及填写自评问卷。评估了干预的依从性、有用性、可信度以及临床医生的时间使用情况，同时评估了对酒精消费的初步影响。该研究已前瞻性注册为一项临床试验（NCT05037630）。
大多数参与者每天或每周多次使用该干预措施。数字干预被认为是可信且有用的，且未报告有不良反应。每位参与者约有1小时的临床医生时间用于电话评估。在3个月的随访中，组内对酒精消费的初步影响中等（每周标准饮酒量，赫奇斯效应量 = 0.70，95%置信区间 = 0.19 - 1.21；重度饮酒天数，赫奇斯效应量 = 0.60，95%置信区间 = 0.09 - 1.11），这反映出平均每周饮酒量从23杯降至13杯。
用于减少酒精消费的数字心理自我护理似乎既可行又初步有效，但应在更大规模的试验中进一步优化和研究。
