Alcohol Expert System Intervention for Problematic Alcohol Use
Condition: Alcohol-related Disorders; Alcohol Drinking
MeSH terms: Alcohol-Related Disorders; Alcohol Drinking
Study type: Interventional

Summary: 
      In a randomized controlled trial, patients recruited in a general hospital and fulfilling
      criteria for alcohol dependence, alcohol abuse or at-risk drinking will be randomly allocated
      to two conditions:(1) Transtheoretical Model (TTM)-based expert system group, patients
      receive an individualized feedback on drinking norms, health-related risks and core
      constructs of the TTM, augmented by a TTM-based manual, (2) Control group,receiving a booklet
      on health behavior.

      Outcome assessment will be conducted after 12 months. The hypothesis is that individualized
      feedback leads to greater reduction in alcohol consumption and elevated readiness to change
      at follow-up.
    

Detailed description: 
      Background: A promising approach in secondary prevention of problem drinking is to provide
      brief interventions in medical settings. However, brief interventions have not become
      implemented in general practices (GPs) due to insufficient role security and therapeutic
      commitment of physicians. Computerized expert systems can provide very cost-effective means
      of intervention and have been effective in the field of smoking cessation. However, in the
      alcohol field, research on this issue is scarce.

      Objectives: Comparing an expert system based on the Transtheoretical Model of behavior change
      for patients with at-risk drinking, alcohol abuse or alcohol dependence to a control
      condition. Methods: About 2,500 screenings among consecutive general hospital patients aged
      18 to 64 will be conducted. Subjects fulfilling inclusion criteria (severe alcohol dependence
      excluded) will be randomly assigned to one of two conditions with 150 patients each: (1) In
      the TTM-based expert system group, patients receive an individualized feedback on drinking
      norms, health-related risks and core constructs of the TTM, augmented by a TTM-based manual.
      (2) In the control group, participants receive a booklet on health behavior. Outcome
      assessment will be conducted after 12 months. Outcome variables are alcohol consumption,
      stages of change progress and utilization of formal help. Expected impact: Findings are
      expected to provide evidence for a computerized TTM based expert system to be used in primary
      care. This would be the first international results confirming such an approach in the
      alcohol field. If a TTM-based expert system would be effective, this could significantly save
      resources and enhance secondary prevention. Therefore, data are of great public health
      interest. Relationship to the objective of the collaboration: As in the other studies,
      empirical data on new proactive approaches to reach underserved populations in the addiction
      field will be provided. The project will add knowledge on the economical use of
      interventions.
    

Intervention name(s): Expert System Intervention
Intervention type(s): Behavioral
Intervention description(s): Questionnaires on motivation to change and alcohol consumption were assessed in a clinical interview. Data were entered in a Computer and a fully automatized feedback letter was generated by an expert system. The printed feedback letter was handed out to patients by study staff the following day.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Expert system; Transtheoretical Model of Behavior Change; Brief intervention; General hospital