Abstract
BackgroundA randomized controlled study (RCT) recently showed that short-term heart rate variability (HRV) biofeedback in addition to standard rehabilitation care for alcohol dependence can reduce craving, anxiety and improve cardiovascular autonomic function. In this one-year follow-up study we aimed to explore whether completion of 2-week HRV-Biofeedback training is associated with long-term abstinence. Furthermore, we sought to identify potential predictors of post-treatment abstinence.MethodsWe conducted a survey on abstinence in patients with alcohol dependence 1 year after completion of an RCT comparing HRV-biofeedback in addition to inpatient rehabilitation treatment alone (controls). Abstinence rates were compared and analysed for association with demographic data as well as psychometric and autonomic cardiac assessment before and after completion of the biofeedback training using bivariate and multivariate regression analyses.ResultsOut of 48 patients who participated in the RCT, 27 patients (9 females, ages 42.9 ± 8.6, mean ± SD) completed our one-year follow-up. When including in the analysis only patients who completed follow-up, the rate of abstinence tended to be higher in patients who underwent HRV-biofeedback 1 year earlier compared to those who received rehabilitative treatment alone (66.7% vs 50%, p = ns). This non-significant trend was also observed in the intention-to-treat analysis where patients who did not participate in the follow-up were assumed to have relapsed (46,7% biofeedback vs. 33.3% controls, p = ns). Neither cardiac autonomic function nor psychometric variables were associated with abstinence 1 year after HRV-biofeedback.ConclusionOur follow-up study provide a first indication of possible increase in long-term abstinence after HRV-biofeedback for alcohol dependence in addition to rehabilitation.Trial registrationThe original randomized controlled trial was registered in the German Clinical Trials Register (DRKS00004618). This one-year follow-up survey has not been registered.
Highlights
A randomized controlled study (RCT) recently showed that short-term heart rate variability (HRV) biofeedback in addition to standard rehabilitation care for alcohol dependence can reduce craving, anxiety and improve cardiovascular autonomic function
We recently showed in a randomized controlled study that heart rate variability (HRV) biofeedback in addition to standard rehabilitation care for alcohol dependence can reduce craving and anxiety more effectively than rehabilitative treatment alone [10]
Study design and population This is a one-year follow-up survey study after a randomized controlled trial on the effects of HRVbiofeedback on cardiac autonomic function assessed via time and frequency domain parameters of HRV, autonomic neurovascular function assessed via laser Doppler flowmetry of cutaneous blood flow after sympathetic stimulation as well as craving, anxiety and depressive symptoms evaluated using psychometric tests
Summary
A randomized controlled study (RCT) recently showed that short-term heart rate variability (HRV) biofeedback in addition to standard rehabilitation care for alcohol dependence can reduce craving, anxiety and improve cardiovascular autonomic function. In this one-year follow-up study we aimed to explore whether completion of 2-week HRV-Biofeedback training is associated with long-term abstinence. We recently showed in a randomized controlled study that heart rate variability (HRV) biofeedback in addition to standard rehabilitation care for alcohol dependence can reduce craving and anxiety more effectively than rehabilitative treatment alone [10]. Our short-term follow-up data did not answer the question whether the observed improvements in psychometric and cardiac autonomic endpoints translate into reduced risk of post-treatment relapse
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