Effectiveness of guided and unguided low-intensity Internet interventions for adult alcohol misuse: A meta-analysis

Heleen Riper, Matthijs Blankers, Hana Hadiwijaya, John Cunningham, Stella Clarke, Reinout Wiers, David Ebert, Pim Cuijpers

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Abstract

Background
Alcohol misuse ranks within the top ten health conditions with the highest global burden of disease. Low-intensity, Internet interventions for curbing adult alcohol misuse have been shown effective. Few meta-analyses have been carried out, however, and they have involved small numbers of studies, lacked indicators of drinking within low risk guidelines, and examined the effectiveness of unguided self-help only. We therefore conducted a more thorough meta-analysis that included both guided and unguided interventions.
Methods
Systematic literature searches were performed up to September 2013. Primary outcome was the mean level of alcohol consumption and drinking within low risk guidelines for alcohol consumption at post-treatment.
Findings
We selected 16 randomised controlled trials (with 23 comparisons and 5,612 participants) for inclusion. Results, showed a small but significant overall effect size in favour of Internet interventions (g = 0.20, 95% CI: 0.13–0.27, p<.001). Participants in Internet interventions drunk on average 22 grams of ethanol less than controls and were significantly more likely to be adhering to low-risk drinking guidelines at post-treatment (RD 0.13, 95% CI: 0.09–0.17, p<.001). Subgroup analyses revealed no significant differences in potential moderators for the outcome of alcohol consumption, although there was a near-significant difference between comparisons with waitlist control and those with assessment-only or alcohol information control conditions (p = .056).
Conclusions
Internet interventions are effective in reducing adult alcohol consumption and inducing alcohol users to adhere to guidelines for low-risk drinking. This effect is small but from a public health point of view this may warrant large scale implementation at low cost of Internet interventions for adult alcohol misuse. Moderator analyses with sufficient power are, however, needed in order to assess the robustness of these overall results and to assess whether these interventions may impact on subgroups with different levels of success.
Original languageEnglish
Article numbere99912
JournalPLoS ONE
Volume9
Issue number6
DOIs
Publication statusPublished - 2014

Cite this

Riper, H., Blankers, M., Hadiwijaya, H., Cunningham, J., Clarke, S., Wiers, R., Ebert, D., & Cuijpers, P. (2014). Effectiveness of guided and unguided low-intensity Internet interventions for adult alcohol misuse: A meta-analysis. PLoS ONE, 9(6), [e99912]. https://doi.org/10.1371/journal.pone.0099912