Abstract
Background and aim
Most people with alcohol use disorder (AUD) are never treated. Internet‐based interventions are effective in reducing alcohol consumption and could help overcome some of the barriers to people not seeking or receiving treatment. The aim of the current study was to compare internet‐delivered and face‐to‐face treatment among adult users with AUD.
Design
Randomized controlled non‐inferiority trial with a parallel design, comparing internet‐delivered cognitive‐behavioural therapy (ICBT) (n=150) with face‐to‐face CBT (n=151), at three‐ and six‐month follow‐ups.
Setting
A specialized clinic for people with AUD in Stockholm, Sweden. Participants were recruited between 8 December, 2015, and 5 January, 2018.
Participants
301 patients (mean age 50 years [SD 12.3]) with AUD, of whom 115 (38%) were female and 186 (62%) were male.
Intervention and Comparator
Participants were randomized in blocks of 20 at a ratio of 1:1 to five modules of therapist‐guided ICBT or to five modules of face‐to‐face CBT, delivered over a three‐month period. The same treatment material and the same therapists were used in both groups.
Measurements
The primary outcome was standard drinks of alcohol consumed during the previous week at six‐month follow‐up, analysed according to intention‐to‐treat. The prespecified non‐inferiority limit was 5 standard drinks of alcohol and d=0.32 for secondary outcomes.
Results
The difference in alcohol consumption between the internet and the face‐to‐face group was non‐inferior in the intention‐to‐treat analysis of data from the six‐month follow‐up (internet=12.33 and face‐to‐face=11.43, difference=0.89, 95 CI=‐1.1 to 2.88). The secondary outcome, Alcohol Use Disorder Identification Test score, failed to show non‐inferiority of internet compared with face‐to‐face in the intention‐to‐treat analysis at six‐month follow‐up (internet=12.26 and face‐to‐face=11.57, d=0.11, 95 CI=‐0.11 to 0.34).
Conclusions
Internet‐delivered treatment was non‐inferior to face‐to‐face treatment in reducing alcohol consumption among help‐seeking patients with alcohol use disorder but failed to show non‐inferiority on some secondary outcomes.