Khatore Payal, Yolanda Hizkia, Joyner Jaeden, Nadkarni Abhijit
Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Department of Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Oxf Open Digit Health. 2025 Jan 12;3:oqaf004. doi: 10.1093/oodh/oqaf004. eCollection 2025.
Despite the high burden of alcohol use and alcohol use disorders (AUDs) in low-and-middle-income countries (LMICs), access to health care is poor. Digital interventions (DIs) have recently emerged as promising avenues for addressing substance use. Such interventions could potentially address barriers to help-seeking in LMICs, such as travel costs, shortage of professionals, stigma, etc.
To synthesize evidence on the effectiveness and implementation of DIs for AUDs in LMICs.
The systematic review had a comprehensive search strategy that combined search terms for DIs (e.g. SMS, eHealth), alcohol use (e.g. hazardous drinking) and LMICs (e.g. India). Studies presenting primary data that reported effectiveness (e.g. relapse) and/or implementation or intervention-related outcomes (e.g. feasibility) of DIs for AUDs in LMICs were eligible. Three databases (EMBASE, MEDLINE and PsycINFO) were searched from their inception till June 2023. Data was extracted in relevant categories and analysed.
Twenty-one reports from 19 studies were included. Types of DIs ranged from standalone mobile applications and web portals to human-delivered interventions via digital platforms. 12 studies reported positive or partially positive alcohol use outcomes (e.g. number of drinking days, abstinence). DIs with human involvement were found to be more effective than standalone DIs. Additionally, high levels of acceptability, feasibility and satisfaction were reported across interventions.
DIs are acceptable and feasible in LMICs and broadly effective in improving alcohol use outcomes. Firm conclusions could not be drawn because of methodological issues such as small sample sizes, short follow-up periods and limited generalisability. Adequate investment, improved research methodology and increased focus on implementation outcomes are required for determining the role that DIs can play in addressing AUDs in LMICs.
尽管中低收入国家（LMICs）的酒精使用和酒精使用障碍（AUDs）负担沉重，但获得医疗保健的机会却很差。数字干预措施（DIs）最近已成为解决物质使用问题的有前景的途径。此类干预措施有可能解决中低收入国家寻求帮助的障碍，如差旅费、专业人员短缺、耻辱感等。
综合关于中低收入国家酒精使用障碍数字干预措施的有效性和实施情况的证据。
该系统评价采用了全面的检索策略，结合了数字干预措施（如短信、电子健康）、酒精使用（如危险饮酒）和中低收入国家（如印度）的检索词。呈现报告中低收入国家酒精使用障碍数字干预措施有效性（如复发）和/或实施或干预相关结果（如可行性）的原始数据的研究符合纳入标准。检索了三个数据库（EMBASE、MEDLINE和PsycINFO），从其创建至2023年6月。按相关类别提取数据并进行分析。
纳入了19项研究的21份报告。数字干预措施的类型从独立的移动应用程序和门户网站到通过数字平台提供的人工干预措施不等。12项研究报告了酒精使用的积极或部分积极结果（如饮酒天数、戒酒）。发现有人参与的数字干预措施比独立的数字干预措施更有效。此外，各项干预措施的可接受性、可行性和满意度都很高。
数字干预措施在中低收入国家是可接受且可行的，并且在改善酒精使用结果方面具有广泛的有效性。由于样本量小、随访期短和普遍性有限等方法学问题，无法得出确凿结论。确定数字干预措施在解决中低收入国家酒精使用障碍方面可发挥的作用，需要进行充分投资、改进研究方法并更多地关注实施结果。
