Abstract
BackgroundAlcohol telephone helplines targeting alcohol consumers in the general population can extend the reach of brief interventions while preserving in-person counselling. So far, studies of client outcomes in the setting of alcohol helplines are scarce. This study aims to compare the 6-months alcohol-related outcomes of two counselling models delivered at the Swedish National Alcohol Helpline.MethodsA pragmatic randomised trial was set up at the Swedish National Alcohol Helpline. First-time callers with current hazardous or harmful alcohol use who contacted the helpline, from May 2015 to December 2017, were invited to participate. Clients were allocated with 1:1 ratio to two groups: (1) brief, structured intervention (n = 128), including self-help material and one counsellor-initiated call, and (2) usual care (n = 133), i.e. multiple-session counselling using Motivational Interviewing (MI). The primary outcome was a downward change in AUDIT risk-zone between baseline and 6-months follow-up. The analysis followed an intention-to-treat approach.ResultsRecruitment ended in December 2017. At 6-months follow-up, 70% of the enrolled participants had data on the outcome. In the brief, structured intervention (n = 107) 68% changed to a lower risk-level, compared to 61% in the usual care group (n = 117), yielding a risk ratio (RR) of 1.12 (95% CI 0.93 to 1.37) and risk difference of 0.08 (95% CI -0.05 to 0.20). The total AUDIT score and the scores from the AUDIT consumption questions (AUDIT-C) did not reveal any between-group differences in the mean change at follow-up.ConclusionsThe counselling at the Swedish National Alcohol Helpline was followed by a significant decrease in alcohol use among clients, without clear superiority for either counselling model.Trial registrationThis trial was retrospectively registered with ISRCNT.com (ID: ISRCTN13160878) 18/01/2016.
Highlights
Alcohol telephone helplines targeting alcohol consumers in the general population can extend the reach of brief interventions while preserving in-person counselling
In total 1796 first time callers were screened for eligibility during the recruitment period
In the brief structured intervention 68% were retained while 72% were retained in usual care
Summary
Alcohol telephone helplines targeting alcohol consumers in the general population can extend the reach of brief interventions while preserving in-person counselling. The harm caused by alcohol could be prevented by increasing help -seeking in the population with hazardous or harmful alcohol consumption [3]. The existing studies on brief intervention using telephone counselling typically consist of clinical populations, i.e. not seeking help for alcohol problems per se. These studies suggest that the telephone may be an effective mode for alcohol counselling [18] [19] [20] [21], a suggestion supported by previous reviews on telephone counselling in mental health and addiction [22, 23]. The scant evaluation of alcohol helplines limits the knowledge about effective models of delivery
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