Abstract
Alcohol is one of the leading risk factors for global disease burden and overconsumption leads to a wide variety of negative consequences in everyday life. Digital interventions have shown small positive effects in contributing to reductions in problematic use. Specific research on smartphone apps is sparse and the few studies published indicate effects ranging from negative or null to small or moderate. TeleCoach™, a web-based skills training smartphone app, has shown positive effects in non-treatment-seeking university students with excessive drinking. This pilot trial aimed to evaluate app effects in a sample of internet help-seekers from the general population in Sweden. A total of 89 participants were recruited via online advertisement. Following baseline assessment for hazardous use, they were randomized to TeleCoach or a web-based control app offering brief information and advice regarding problematic alcohol use. The primary outcome was number of standard drinks per week; secondary outcomes included drinking quantity and frequency, binge drinking and blood alcohol count measures as well as app user data and comorbidity related to depression, anxiety, and drug use. Analysis of baseline and 6-week follow-up outcomes showed significant within-group effects on alcohol consumption but no significant between-group differences. Effect sizes for the within-group changes in the primary outcome over time were significant [F(1, 55)=43.98; p < 0.001], with a Cohen's d of 1.37 for the intervention group and 0.92 for the control group. This difference in effect sizes indicated that continuation of the study as a large randomized, controlled trial with up to 1,000 participants could be worthwhile.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT03696888.
Highlights
Alcohol is one of the most commonly used and socially accepted psychoactive substances worldwide, with overconsumption leading to significant impacts on individual levels and on societal levels
The findings show that alcohol consumption declined with large effect sizes in both intervention and control groups, nominally favoring the intervention group but lacking between-group statistical significance
The present study shows promising results in terms of the need for continued data collection in the larger, randomized controlled trial, which in effect is a continuation of the randomized pilot study reported
Summary
Alcohol is one of the most commonly used and socially accepted psychoactive substances worldwide, with overconsumption leading to significant impacts on individual levels and on societal levels. World Health Organization (WHO) reports consistently show that alcohol is ranked among the top leading risk factors for the global disease burden associated with premature death and disease. In 2016, 3 million deaths worldwide were attributed to hazardous or harmful use of alcohol. Cardiovascular diseases and digestive diseases resulting from harmful alcohol consumption were among the top leading factors behind alcohol-related deaths in 2016 [1]. In addition to the health-related consequences of increased alcohol consumption, it leads to major financial consequences that burden society, including an increased need of health care, increased criminality and a loss of productivity. Implementing interventions on a societal level to lower these economic burdens could potentially save hundreds of millions of dollars per year [2]
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