Problematic AOD Use
Conditions
Keywords
Randomized Controlled Trial, Alcohol, Drugs, Internet, Screening, Brief intervention
Brief summary
Objectives: This study compared the efficacy of eScreen in a two-armed randomized controlled design, measuring outcomes in terms of changes in problematic drug use up to one year after study recruitment. The eScreen brief Internet intervention for problematic alcohol and drug use offers self-screening, in-depth self-reporting, personalized feedback and treatment recommendations as well as an electronic diary. Progress over time is shown in diagrams detailing consumption levels. Method: Participants with only problematic drug use according to the Drug Use Disorders Identification Test (DUDIT),(DUDIT \>0 for both men and women) or both problematic alcohol use according to the Alcohol Use Disorders Identification Test (AUDIT), (AUDIT \>7 for men and AUDIT \>5 for women) and drug use were randomized to T1 (n=101) or the control group (n=101). Outcomes on alcohol and/or drug use as well as health-related symptoms were assessed after 3, 6 and 12 months. Hypotheses that were tested in this study are 1) that both groups would reduce their drug consumption and drug-related problems at follow-ups compared to the baseline level and 2) that participants in the eScreen group would reduce their drug consumption and drug-related problems to a higher extent than participants in the control group (no intervention) at follow-ups.
Detailed description
Background: The aim of this study is to investigate the effects of an Internet-based screening and brief intervention (SBI) site for problematic alcohol and drug use among illicit drug users. Method: Individuals searching for information about alcohol or drugs online who scored over 0 on the Drug Use Disorders Identification Test (DUDIT) and were 15 years or older were recruited for this trial and randomized into one group receiving Internet-based screening and brief intervention via eScreen.se(n = 101) or one assessment-only control group (n = 101). Both groups were screened at baseline and followed up at 3 and 6 months. The primary outcome measure was the DUDIT-C score and secondary outcome measures were DUDIT, AUDIT-C (Alcohol Use Disorders Identification Test-C) and AUDIT scores.Additional outcomes included the proportion of drug abstainers and those who made a clinically significant change in their alcohol and drug use. Four statistical models of analysis were used to conservatively assess results.
Interventions
BEHAVIORALeScreen
Web based self-monitoring of problematic alcohol and drug use.
Sponsors
Karolinska Institutet
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
15 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* DUDIT \>0
Exclusion criteria
* DUDIT = 0
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Drug Use Disorders Identification Test-Consumption (DUDIT-C) | 3 months | The primary outcome measure for this trial was the total DUDIT score for the first four DUDIT questions at 3-month follow-up, as a measure of drug consumption only, referred to as the DUDIT-C.The DUDIT-C is a measure including the first four items of the DUDIT, with a minimum score of 0 and a maximum score of 16. Higher scores mean a worse outcome. Regarding the DUDIT-C, you will find information on it in the following articles. Please note that the analyses all refer to the same sample from a randomized controlled trial. Apart from the data in the two articles describing results from the current study, there are additional analyses shown in: Berman, A. H., Wennberg, P., & Sinadinovic, K. (2015). Changes in Mental and Physical Well-Being Among Problematic Alcohol and Drug Users in 12-Month Internet-Based Intervention Trials. Psychology of Addictive Behaviors, 29(1), 97-105. doi: 10.1037/a0038420 A higher score means a worse outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) | 3 months | The total AUDIT score for the first three AUDIT questions at 3-month follow-up, as a measure of alcohol consumption only, referred to as the AUDIT-C. The AUDIT-C, a 3-item scale, has a minimum score of 0 and a maximum score of 12. Higher scores mean a worse outcome. |
| Alcohol Use Disorders Identification Test - AUDIT | 3 months | The total AUDIT score at 3-month follow-up, as a summarized measure of alcohol use (including alcohol consumption and alcohol-related problems). The AUDIT, an 10-item scale, has a minimum score of 0 and a maximum score of 40. Higher scores mean a worse outcome. |
| Drug Use Disorders Identification Test (DUDIT) | 3 months | The total DUDIT score at 3-month follow-up, as a summarized measure of drug use (including drug consumption and drug-related problems). The DUDIT, an 11-item scale, has a minimum score of 0 and a maximum score of 44. Higher scores mean a worse outcome. |
| Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) | 6 months | The total AUDIT score for the first three AUDIT questions at 6-month follow-up, as a measure of alcohol consumption only, referred to as the AUDIT-C. The AUDIT-C, a 3-item scale, has a minimum score of 0 and a maximum score of 12. Higher scores mean a worse outcome. |
| Alcohol Use Disorders Identification Test (AUDIT) | 6 months | The total AUDIT score at 6-month follow-up, as a summarized measure of drug use (including alcohol consumption and alcohol-related problems). The AUDIT, an 10-item scale, has a minimum score of 0 and a maximum score of 40. Higher scores mean a worse outcome. |
| Drug Use Disorders Identification Test-Consumption (DUDIT-C) | 6 months | The total DUDIT score for the first four DUDIT questions at 6-month follow-up, as a measure of drug consumption only, referred to as the DUDIT-C.The DUDIT-C is a measure including the first four items of the DUDIT, with a minimum score of 0 and a maximum score of 16. Higher scores mean a worse outcome. |
Countries
Sweden
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| eScreen Web based self-monitoring of problematic alcohol and drug use.
eScreen: Web based self-monitoring of problematic alcohol and drug use. | 101 |
| Control Group Untreated control group | 101 |
| Total | 202 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| 12-month Follow-up | Lost to Follow-up | 69 | 67 |
| 3-month Follow-up | Lost to Follow-up | 68 | 68 |
| 6-month Follow-up | Lost to Follow-up | 74 | 66 |
Baseline characteristics
| Characteristic | Control Group | eScreen | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 4 Participants | 5 Participants | 9 Participants |
| Age, Categorical >=65 years | 2 Participants | 1 Participants | 3 Participants |
| Age, Categorical Between 18 and 65 years | 95 Participants | 95 Participants | 190 Participants |
| Age, Continuous | 31.93 years STANDARD_DEVIATION 12.37 | 33.16 years STANDARD_DEVIATION 13.34 | 32.54 years STANDARD_DEVIATION 12.84 |
| Region of Enrollment Sweden | 101 participants | 101 participants | 202 participants |
| Sex: Female, Male Female | 42 Participants | 48 Participants | 90 Participants |
| Sex: Female, Male Male | 59 Participants | 53 Participants | 112 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 101 | 0 / 101 |
| serious Total, serious adverse events | 0 / 101 | 0 / 101 |
Outcome results
Primary
Drug Use Disorders Identification Test-Consumption (DUDIT-C)
The primary outcome measure for this trial was the total DUDIT score for the first four DUDIT questions at 3-month follow-up, as a measure of drug consumption only, referred to as the DUDIT-C.The DUDIT-C is a measure including the first four items of the DUDIT, with a minimum score of 0 and a maximum score of 16. Higher scores mean a worse outcome. Regarding the DUDIT-C, you will find information on it in the following articles. Please note that the analyses all refer to the same sample from a randomized controlled trial. Apart from the data in the two articles describing results from the current study, there are additional analyses shown in: Berman, A. H., Wennberg, P., & Sinadinovic, K. (2015). Changes in Mental and Physical Well-Being Among Problematic Alcohol and Drug Users in 12-Month Internet-Based Intervention Trials. Psychology of Addictive Behaviors, 29(1), 97-105. doi: 10.1037/a0038420 A higher score means a worse outcome.
Time frame: 3 months
Population: The analyses have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP).~Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Drug Use Disorders Identification Test-Consumption (DUDIT-C) | 4.8 units on a scale | Standard Deviation 3.9 |
| Control Group | Drug Use Disorders Identification Test-Consumption (DUDIT-C) | 4.5 units on a scale | Standard Deviation 4.1 |
Secondary
Alcohol Use Disorders Identification Test - AUDIT
The total AUDIT score at 3-month follow-up, as a summarized measure of alcohol use (including alcohol consumption and alcohol-related problems). The AUDIT, an 10-item scale, has a minimum score of 0 and a maximum score of 40. Higher scores mean a worse outcome.
Time frame: 3 months
Population: The analyzes have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP).~Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Alcohol Use Disorders Identification Test - AUDIT | 18.5 units on a scale | Standard Deviation 10.1 |
| Control Group | Alcohol Use Disorders Identification Test - AUDIT | 17.7 units on a scale | Standard Deviation 10.9 |
Secondary
Alcohol Use Disorders Identification Test (AUDIT)
The total AUDIT score at 12-month follow-up, as a summarized measure of drug use (including alcohol consumption and alcohol-related problems). The AUDIT, an 10-item scale, has a minimum score of 0 and a maximum score of 40. Higher scores mean a worse outcome.
Time frame: 12 months
Population: The analyzes have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP). Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Alcohol Use Disorders Identification Test (AUDIT) | 16.9 units on a scale | Standard Deviation 10.8 |
| Control Group | Alcohol Use Disorders Identification Test (AUDIT) | 17.1 units on a scale | Standard Deviation 10.5 |
Secondary
Alcohol Use Disorders Identification Test (AUDIT)
The total AUDIT score at 6-month follow-up, as a summarized measure of drug use (including alcohol consumption and alcohol-related problems). The AUDIT, an 10-item scale, has a minimum score of 0 and a maximum score of 40. Higher scores mean a worse outcome.
Time frame: 6 months
Population: The analyzes have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP). Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Alcohol Use Disorders Identification Test (AUDIT) | 17.4 units on a scale | Standard Deviation 10.7 |
| Control Group | Alcohol Use Disorders Identification Test (AUDIT) | 17.3 units on a scale | Standard Deviation 10.7 |
Secondary
Alcohol Use Disorders Identification Test - Consumption (AUDIT-C)
The total AUDIT score for the first three AUDIT questions at 3-month follow-up, as a measure of alcohol consumption only, referred to as the AUDIT-C. The AUDIT-C, a 3-item scale, has a minimum score of 0 and a maximum score of 12. Higher scores mean a worse outcome.
Time frame: 3 months
Population: The analyzes have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP).~Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) | 6.9 units on a scale | Standard Deviation 3.1 |
| Control Group | Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) | 6.7 units on a scale | Standard Deviation 3.4 |
Secondary
Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)
The total AUDIT score for the first three AUDIT questions at 12-month follow-up, as a measure of alcohol consumption only, referred to as the AUDIT-C. The AUDIT-C, a 3-item scale, has a minimum score of 0 and a maximum score of 12. Higher scores mean a worse outcome.
Time frame: 12 months
Population: The analyzes have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP). Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) | 6.3 units on a scale | Standard Deviation 3.3 |
| Control Group | Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) | 6.5 units on a scale | Standard Deviation 3.4 |
Secondary
Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)
The total AUDIT score for the first three AUDIT questions at 6-month follow-up, as a measure of alcohol consumption only, referred to as the AUDIT-C. The AUDIT-C, a 3-item scale, has a minimum score of 0 and a maximum score of 12. Higher scores mean a worse outcome.
Time frame: 6 months
Population: The analyzes have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP). Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) | 6.5 units on a scale | Standard Deviation 3.3 |
| Control Group | Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) | 6.5 units on a scale | Standard Deviation 3.4 |
Secondary
Drug Use Disorders Identification Test-Consumption (DUDIT-C)
The total DUDIT score for the first four DUDIT questions at 12-month follow-up, as a measure of drug consumption only, referred to as the DUDIT-C.The DUDIT-C is a measure including the first four items of the DUDIT, with a minimum score of 0 and a maximum score of 16. Higher scores mean a worse outcome.
Time frame: 12 months
Population: The analyzes have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP). Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Drug Use Disorders Identification Test-Consumption (DUDIT-C) | 4.4 units on a scale | Standard Deviation 4.2 |
| Control Group | Drug Use Disorders Identification Test-Consumption (DUDIT-C) | 4.0 units on a scale | Standard Deviation 4.1 |
Secondary
Drug Use Disorders Identification Test-Consumption (DUDIT-C)
The total DUDIT score for the first four DUDIT questions at 6-month follow-up, as a measure of drug consumption only, referred to as the DUDIT-C.The DUDIT-C is a measure including the first four items of the DUDIT, with a minimum score of 0 and a maximum score of 16. Higher scores mean a worse outcome.
Time frame: 6 months
Population: The analyzes have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP).~Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Drug Use Disorders Identification Test-Consumption (DUDIT-C) | 4.7 units on a scale | Standard Deviation 4.2 |
| Control Group | Drug Use Disorders Identification Test-Consumption (DUDIT-C) | 4.2 units on a scale | Standard Deviation 4.1 |
Secondary
Drug Use Disorders Identification Test (DUDIT)
The total DUDIT score at 12-month follow-up, as a summarized measure of drug use (including drug consumption and drug-related problems). The DUDIT, an 11-item scale, has a minimum score of 0 and a maximum score of 44. Higher scores mean a worse outcome.
Time frame: 12 months
Population: The analyzes have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP). Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Drug Use Disorders Identification Test (DUDIT) | 11.0 units on a scale | Standard Deviation 12.8 |
| Control Group | Drug Use Disorders Identification Test (DUDIT) | 9.9 units on a scale | Standard Deviation 12.2 |
Secondary
Drug Use Disorders Identification Test (DUDIT)
The total DUDIT score at 3-month follow-up, as a summarized measure of drug use (including drug consumption and drug-related problems). The DUDIT, an 11-item scale, has a minimum score of 0 and a maximum score of 44. Higher scores mean a worse outcome.
Time frame: 3 months
Population: The analyzes have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP).~Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Drug Use Disorders Identification Test (DUDIT) | 12.0 units on a scale | Standard Deviation 12.6 |
| Control Group | Drug Use Disorders Identification Test (DUDIT) | 10.6 units on a scale | Standard Deviation 12.1 |
Secondary
Drug Use Disorders Identification Test (DUDIT)
The total DUDIT score at 6-month follow-up, as a summarized measure of drug use (including drug consumption and drug-related problems). The DUDIT, an 11-item scale, has a minimum score of 0 and a maximum score of 44. Higher scores mean a worse outcome.
Time frame: 6 months
Population: The analyzes have been carried out according to both the Intention To Treat method (ITT) and according to Per protocols method (PP). Where possible, missing values were imputed with last observation carried backwards. In cases where no follow-up data were available, the last observation was carried forward.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| eScreen | Drug Use Disorders Identification Test (DUDIT) | 11.6 units on a scale | Standard Deviation 12.8 |
| Control Group | Drug Use Disorders Identification Test (DUDIT) | 10.4 units on a scale | Standard Deviation 12.2 |