Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Previous article
Next article

Persönliche vs. computerbasierte Alkoholintervention für Krankenhauspatienten: Studiendesign

Published Online:December 18, 2015https://doi.org/10.1024/0939-5911.a000394

Abstract

Zusammenfassung.Ziel: Persönliche Beratungen können bei stationären Krankenhauspatienten Alkoholkonsum und Mortalität reduzieren. Sie sind jedoch mit hohen Kosten verbunden, wenn aus Public-Health-Erfordernis viele Menschen einer Bevölkerung erreicht werden müssen. Computerbasierte Interventionen stellen eine Alternative dar. Jedoch ist ihre Wirksamkeit im Vergleich zu persönlichen Beratungen und im Allgemeinkrankenhaus noch unklar. Eine quasi-randomisierte Kontrollgruppenstudie „Die Bedeutung der Vermittlungsform für Alkoholinterventionen bei Allgemeinkrankenhauspatienten: Persönlich vs. Computerisiert“ soll dies untersuchen. Design und Methoden werden beschrieben. Methode: Über 18 Monate sind alle 18- bis 64-jährigen Patienten auf Stationen der Universitätsmedizin Greifswald mittels Alcohol Use Disorder Identification Test (AUDIT) zu screenen. Frauen/Männer mit AUDIT-Consumption ≥ 4/5 und AUDIT < 20 werden einer von drei Gruppen zugeordnet: persönliche Intervention (Beratungen zur Konsumreduktion), computerbasierte Intervention (individualisierte Rückmeldebriefe und Broschüren) und Kontrollgruppe. Beide Interventionen erfolgen im Krankenhaus sowie telefonisch bzw. postalisch nach 1 und 3 Monaten. In computergestützten Telefoninterviews nach 6, 12, 18 und 24 Monaten wird Alkoholkonsum erfragt. Schlussfolgerung: Das Studienvorhaben, sofern erfolgreich umgesetzt, ist geeignet die längerfristige Wirksamkeit einer persönlichen und computerbasierten Intervention im Vergleich zu untersuchen.


In-person vs. Computer-based Alcohol Interventions among General Hospital Inpatients: Study Design

Abstract.Background: In-person interventions have the potential to reduce alcohol use among general hospital inpatients with unhealthy alcohol use. However, they can trigger high costs when many people need to be reached for public health purposes. Computer-based interventions may provide an alternative, though little is known about their efficacy, also in comparison to in-person interventions in the general hospital setting. This is to be investigated by the quasi-randomized controlled trial “Testing delivery channels of alcohol interventions among general hospital inpatients: in-PErson versus COmputer-based, PECO” described in this paper. Methods: Over a period of 18 months all general hospital inpatients aged 18 – 64 years on selected wards of the University Medicine Greifswald are to be screened using the Alcohol Use Disorder Identification Test (AUDIT). Women/men with AUDIT-Consumption ≥ 4/5, and AUDIT< 20 are eligible for trial inclusion. Participants are randomized to in-person intervention (counseling by a trained counselor), computer-based intervention (computer-generated individualized feedback letters) and control group (treatment as usual, minimal assessment only). Both interventions are provided on the ward as well as 1 and 3 months later by phone and mail, respectively. Computer-assisted telephone follow-up interviews are conducted after 6, 12, 18 and 24 months. Self-reported alcohol use is assessed as the primary outcome. Conclusion: The study, if implemented successfully, is suitable to investigate the long-term efficacy of in-person and computer-based delivered interventions among general hospital inpatients.

Literatur

  • Babor, T. F., Steinberg, K., Anton, R. & Del Boca, F. (2000). Talk is cheap: measuring drinking outcomes in clinical trials. Journal of Studies on Alcohol and Drugs, 61, 55 – 63. First citation in articleCrossref, Google Scholar

  • Bischof, G., Freyer-Adam, J., Meyer, C., John, U. & Rumpf, H. J. (2012). Changes in drinking behavior among control group participants in early intervention studies targeting unhealthy alcohol use recruited in general hospitals and general practices. Drug and Alcohol Dependence, 125, 81 – 88. First citation in articleCrossref, Google Scholar

  • Bischof, G., Grothues, J. M., Reinhardt, S., Meyer, C., John, U. & Rumpf, H. J. (2008). Evaluation of a telephone-based stepped care intervention for alcohol-related disorders: a randomized controlled trial. Drug and Alcohol Dependence, 93, 244 – 251. First citation in articleCrossref, Google Scholar

  • Bischof, G., Reinhardt, S., Grothues, J., John, U. & Rumpf, H.-J. (2007). The Expert Test and Report on alcohol (EXTRA): Development and evaluation of a computerized software program for problem drinkers. In D. R. Baye (Ed.), New Research on Alcoholism. New York: Nova Science Publishers, Inc. First citation in articleGoogle Scholar

  • Bush, K., Kivlahan, D. R., McDonell, M. B., Fihn, S. D. & Bradley, K. A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arcives of Internal Medicine, 158, 1789 – 1795. First citation in articleCrossref, Google Scholar

  • Cadigan, J. M., Haeny, A. M., Martens, M. P., Weaver, C. C., Takamatsu, S. K. & Arterberry, B. J. (2015). Personalized Drinking Feedback: A Meta-Analysis of In-Person Versus Computer-Delivered Interventions. Journal of Consulting and Clinical Psychology, l 83, 430 – 437. First citation in articleCrossref, Google Scholar

  • Carey, K. B., Scott-Sheldon, L. A., Elliott, J. C., Garey, L. & Carey, M. P. (2012). Face-to-face versus computer-delivered alcohol interventions for college drinkers: a meta-analytic review, 1998 to 2010. Clinical Psychology Review, 32, 690 – 703. First citation in articleCrossref, Google Scholar

  • Del Boca, F. K. & Darkes, J. (2003). The validity of self-reports of alcohol consumption: state of the science and challenges for research. Addiction, 98 Suppl 2, 1 – 12. First citation in articleCrossref, Google Scholar

  • Deutsche Hauptstelle für Suchtfragen (Ed.). (2008). Umgang mit Alkohol: Informationen, Test und Hilfen in 5 Phasen. Hamm: Deutsche Hauptstelle für Suchtfragen. First citation in articleGoogle Scholar

  • Donovan, D. M., Kivlahan, D. R., Doyle, S. R., Longabaugh, R. & Greenfield, S. F. (2006). Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT zones in defining levels of severity among out-patients with alcohol dependence in the COMBINE study. Addiction, 101, 1696 – 1704. First citation in articleCrossref, Google Scholar

  • Freyer-Adam, J., Baumann, S., Schnuerer, I., Haberecht, K., Bischof, G. & John, U., et al. (2014). Does stage tailoring matter in brief alcohol interventions for job-seekers? A randomized controlled trial. Addiction, 109, 1845 – 1856. First citation in articleCrossref, Google Scholar

  • Freyer-Adam, J., Coder, B., Baumeister, S. E., Bischof, G., Riedel, J. & Paatsch, K., et al. (2008). Brief alcohol intervention for general hospital inpatients: a randomized controlled trial. Drug and Alcohol Dependence, 93, 233 – 243. First citation in articleCrossref, Google Scholar

  • Khadjesari, Z., Murray, E., Hewitt, C., Hartley, S. & Godfrey, C. (2011). Can stand-alone computer-based interventions reduce alcohol consumption? A systematic review. Addiction, 06, 267 – 282. First citation in articleCrossref, Google Scholar

  • Kypri, K., Langley, J. D., Saunders, J. B., Cashell-Smith, M. L. & Herbison, P. (2008). Randomized controlled trial of web-based alcohol screening and brief intervention in primary care. Archives of Internal Medicine, 168, 530 – 536. First citation in articleCrossref, Google Scholar

  • McQueen, J., Howe, T. E., Allan, L., Mains, D. & Hardy, V. (2011). Brief interventions for heavy alcohol users admitted to general hospital wards. Cochrane Database Syst Rev(8), CD005191. First citation in articleCrossref, Google Scholar

  • Mdege, N. D., Fayter, D., Watson, J. M., Stirk, L., Sowden, A. & Godfrey, C. (2013). Interventions for reducing alcohol consumption among general hospital inpatient heavy alcohol users: a systematic review. Drug and Alcohol Dependence, 131, 1 – 22. First citation in articleCrossref, Google Scholar

  • Meyer, C., Ulbricht, S., Baumeister, S. E., Schumann, A., Ruege, J. & Bischof, G., et al. (2008). Efficacy of computer tailored letters and physician delivered counselling for smoking cessation in general practices: Randomised controlled trial. Addiction, 103, 294 – 304. First citation in articleCrossref, Google Scholar

  • Miller, W. R. & Rollnick, S. (2002). Motivational Interviewing. Preparing people for change. New York, NY: The Guilford Press. First citation in articleGoogle Scholar

  • Monti, P. M., Barnett, N. P., Colby, S. M., Gwaltney, C. J., Spirito, A. & Rohsenow, D. J., et al. (2007). Motivational interviewing versus feedback only in emergency care for young adult problem drinking. Addiction, 102, 1234 – 1243. First citation in articleCrossref, Google Scholar

  • Moyer, A., Finney, J. W., Swearingen, C. E. & Vergun, P. (2002). Brief interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations. Addiction, 97, 279 – 292. First citation in articleCrossref, Google Scholar

  • Moyers, T. B., Martin, T., Manuel, J. K., Miller, W. R. & Ernst, D. (2010). Revised Global Scales: Motivational Interviewing Treatment Integrity 3.1.1 (MITI 3.1.1). http://casaa.unm.edu/download/MITI3_1.pdf. First citation in articleGoogle Scholar

  • Neumann, T., Neuner, B., Weiss-Gerlach, E., Tonnesen, H., Gentilello, L. M. & Wernecke, K. D., et al. (2006). The effect of computerized tailored brief advice on at-risk drinking in subcritically injured trauma patients. Journal of Trauma and Acute Care Surgery, 61, 805 – 814. First citation in articleCrossref, Google Scholar

  • Prochaska, J. O. & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12, 38 – 48. First citation in articleCrossref, Google Scholar

  • Riper, H., Spek, V., Boon, B., Conijn, B., Kramer, J. & Martin-Abello, K., et al. (2011). Effectiveness of E-self-help interventions for curbing adult problem drinking: a meta-analysis. Journal of Medical Internet Research, 13, e42. First citation in articleCrossref, Google Scholar

  • Rooke, S., Thorsteinsson, E., Karpin, A., Copeland, J. & Allsop, D. (2010). Computer-delivered interventions for alcohol and tobacco use: a meta-analysis. Addiction, 105(8), 1381 – 1390. First citation in articleCrossref, Google Scholar

  • Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R. & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88, 791 – 804. First citation in articleCrossref, Google Scholar

  • Schnuerer, I., Gaertner, B., Baumann, S., Rumpf, H. J., John, U. & Hapke, U., et al. (2013). Gender-specific predictors of risky alcohol use among general hospital inpatients. General Hospital Psychiatry, 35, 9 – 15. First citation in articleCrossref, Google Scholar

  • Seitz, H. K., Bühringer, G. & Mann, K. (2008). Grenzwerte für den Konsum alkoholischer Getränke: Empfehlungen des wissenschaftlichen Kuratoriums der DHS. In Deutsche Hauptstelle für Suchtfragen e.V.Ed., Jahrbuch Sucht 2008 (pp. 205 – 209). Geesthacht: Neuland. First citation in articleGoogle Scholar

  • Velicer, W. F., Prochaska, J. O., Bellis, J. M., DiClemente, C. C., Rossi, J. S. & Fava, J. L., et al. (1993). An expert system intervention for smoking cessation. Addictive Behaviors, 18, 269 – 290. First citation in articleCrossref, Google Scholar

  • Walton, M. A., Chermack, S. T., Shope, J. T., Bingham, C. R., Zimmerman, M. A. & Blow, F. C., et al. (2010). Effects of a brief intervention for reducing violence and alcohol misuse among adolescents: a randomized controlled trial. Jama, 304, 527 – 535. First citation in articleCrossref, Google Scholar