JMIR Ment Health. 2014 Sep 11;1(1):e1. doi: 10.2196/mental.3278. eCollection 2014.
A Web-Based Intervention for Users of Amphetamine-Type Stimulants: 3-Month Outcomes of a Randomized Controlled Trial.
JMIR mental health
Robert J Tait, Rebecca McKetin, Frances Kay-Lambkin, Bradley Carron-Arthur, Anthony Bennett, Kylie Bennett, Helen Christensen, Kathleen M Griffiths
Affiliations
Affiliations
- National Drug Research Institute Faculty of Health Sciences Curtin University Perth Australia ; National Institute for Mental Health Research The Australian National University Canberra Australia.
- Centre for Research on Ageing, Health and Wellbeing The Australian National University Canberra Australia.
- National Drug and Alcohol Research Centre University of New South Wales Sydney Australia ; Centre for Translational Neuroscience and Mental Health University of Newcastle Newcastle Australia.
- National Institute for Mental Health Research The Australian National University Canberra Australia.
- National Institute for Mental Health Research The Australian National University Canberra Australia ; Black Dog Institute University of New South Wales and Prince of Wales Hospital Sydney Australia.
PMID: 26543901
PMCID: PMC4607377 DOI: 10.2196/mental.3278
Abstract
BACKGROUND: Among illicit drugs, the prevalence of amphetamine-type stimulant (ATS) use is second only to cannabis. Currently, there are no approved pharmacotherapies for ATS problems, but some face-to-face psychotherapies are effective. Web-based interventions have proven to be effective for some substance use problems, but none has specifically targeted ATS users.
OBJECTIVE: The objective of the study was to evaluate the effectiveness of a Web-based intervention for ATS problems on a free-to-access site compared with a waitlist control group.
METHODS: We used a randomized controlled trial design. The primary outcome measure was self-reported ATS use in the past three months assessed using the Alcohol, Smoking, Substance Involvement Screening Test (ASSIST). Other measures included quality of life (EUROHIS score), psychological distress (K-10 score), days out of role, poly-drug use, general help-seeking intentions, actual help-seeking, and "readiness to change". The intervention consisted of three fully automated, self-guided modules based on cognitive behavioral therapy and motivation enhancement. The analysis was an intention-to-treat analysis using generalized estimating equation models, with a group by time interaction as the critical assessment.
RESULTS: We randomized 160 people (intervention n=81, control n=79). At three months, 35/81 (43%) intervention and 45/79 (57%) control participants provided follow-up data. In the intervention group, 51/81 (63%) completed at least one module. The only significant group by time interaction was for days out of role. The pre/post change effect sizes showed small changes (range d=0.14 to 0.40) favoring the intervention group for poly-drug use, distress, actual help-seeking, and days out of role. In contrast, the control group was favored by reductions in ATS use, improvements in quality of life, and increases in help-seeking intentions (range d=0.09 to 0.16).
CONCLUSIONS: This Web-based intervention for ATS use produced few significant changes in outcome measures. There were moderate, but nonsignificant reductions in poly-drug use, distress, days partially out of role, and increases in help-seeking. However, high levels of participant attrition, plus low levels of engagement with the modules, preclude firm conclusions being drawn on the efficacy of the intervention and emphasize the problems of engaging this group of clients in a fully automated program.
TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry: ACTRN 12611000947909; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000947909 (Archived by WebCite at http://www.webcitation.org/6SHTxEnzP).
Keywords: Internet; Web-based; World Wide Web; amphetamine related disorders; cognitive therapy; intervention; motivational enhancement; online; randomized control trial
References
- Addiction. 2005 Mar;100(3):367-78 - PubMed
- Addiction. 2002 Mar;97(3):279-92 - PubMed
- Drug Alcohol Rev. 2008 May;27(3):309-17 - PubMed
- Drug Alcohol Depend. 2009 Feb 1;100(1-2):178-81 - PubMed
- Arch Gen Psychiatry. 2004 Mar;61(3):310-7 - PubMed
- J Subst Abuse Treat. 2012 Jan;42(1):25-34 - PubMed
- Psychol Bull. 1992 Jul;112(1):155-9 - PubMed
- Drug Alcohol Depend. 2013 Dec 1;133(2):295-304 - PubMed
- Drug Alcohol Rev. 2008 May;27(3):318-25 - PubMed
- Med J Aust. 2011 Nov 21;195(10):607-9 - PubMed
- Eur J Public Health. 2006 Aug;16(4):420-8 - PubMed
- J Am Med Inform Assoc. 2013 May 1;20(3):568-76 - PubMed
- BMC Psychiatry. 2012 Jul 16;12:81 - PubMed
- Addiction. 2012 Nov;107(11):1998-2008 - PubMed
- Cogn Behav Ther. 2009;38(4):196-205 - PubMed
- Br J Addict. 1992 May;87(5):743-54 - PubMed
- Cochrane Database Syst Rev. 2001;(4):CD003022 - PubMed
- Cochrane Database Syst Rev. 2008 Apr 16;(2):CD000165 - PubMed
- Addiction. 2001 Sep;96(9):1279-87 - PubMed
- Addiction. 1993 Mar;88(3):315-35 - PubMed
- J Med Internet Res. 2011 Dec 31;13(4):e126 - PubMed
- Addiction. 1997 Jul;92(7):839-45 - PubMed
- Drug Alcohol Rev. 2007 Mar;26(2):161-8 - PubMed
- Soc Sci Med. 1994 Aug;39(4):563-72 - PubMed
- BMC Psychiatry. 2012 Jun 25;12:67 - PubMed
- Drug Alcohol Depend. 2006 Dec 1;85(3):198-204 - PubMed
- Psychol Med. 1997 Jul;27(4):861-73 - PubMed
- Int J Methods Psychiatr Res. 2008 Jun;17 Suppl 1:S74-7 - PubMed
- J Med Internet Res. 2012 Nov 28;14(6):e166 - PubMed
- Lancet. 2010 Aug 7;376(9739):458-74 - PubMed
- J Subst Abuse Treat. 2011 Apr;40(3):215-23 - PubMed
- Psychol Med. 2002 Aug;32(6):959-76 - PubMed
- Addiction. 1995 May;90(5):607-14 - PubMed
Publication Types