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Randomized Controlled Trial
. 2019 Jul 8;19(1):213.
doi: 10.1186/s12888-019-2199-z.

A pragmatic randomised trial of two counselling models at the Swedish national alcohol helpline

Eleonor Säfsten  1 , Yvonne Forsell  2   3 , Mats Ramstedt  4   5 , Kerstin Damström Thakker  3 , Maria Rosaria Galanti  2   3
Affiliations
Randomized Controlled Trial

A pragmatic randomised trial of two counselling models at the Swedish national alcohol helpline

Eleonor Säfsten et al. BMC Psychiatry. .

Abstract

Background: Alcohol telephone helplines targeting alcohol consumers in the general population can extend the reach of brief interventions while preserving in-person counselling. So far, studies of client outcomes in the setting of alcohol helplines are scarce. This study aims to compare the 6-months alcohol-related outcomes of two counselling models delivered at the Swedish National Alcohol Helpline.

Methods: A pragmatic randomised trial was set up at the Swedish National Alcohol Helpline. First-time callers with current hazardous or harmful alcohol use who contacted the helpline, from May 2015 to December 2017, were invited to participate. Clients were allocated with 1:1 ratio to two groups: (1) brief, structured intervention (n = 128), including self-help material and one counsellor-initiated call, and (2) usual care (n = 133), i.e. multiple-session counselling using Motivational Interviewing (MI). The primary outcome was a downward change in AUDIT risk-zone between baseline and 6-months follow-up. The analysis followed an intention-to-treat approach.

Results: Recruitment ended in December 2017. At 6-months follow-up, 70% of the enrolled participants had data on the outcome. In the brief, structured intervention (n = 107) 68% changed to a lower risk-level, compared to 61% in the usual care group (n = 117), yielding a risk ratio (RR) of 1.12 (95% CI 0.93 to 1.37) and risk difference of 0.08 (95% CI -0.05 to 0.20). The total AUDIT score and the scores from the AUDIT consumption questions (AUDIT-C) did not reveal any between-group differences in the mean change at follow-up.

Conclusions: The counselling at the Swedish National Alcohol Helpline was followed by a significant decrease in alcohol use among clients, without clear superiority for either counselling model.

Trial registration: This trial was retrospectively registered with ISRCNT.com (ID: ISRCTN13160878 ) 18/01/2016.

Keywords: Brief intervention; Counselling; Drinking; Harmful alcohol use; Hazardous alcohol use; Randomised controlled trial; Telephone helpline.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart over the recruitment, randomisation and follow-up
Fig. 2
Fig. 2
Change in AUDIT risk level (%) between baseline and 6 month follow-up, by intervention group
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References

    1. Institute for Health Metrics and Evaluation (IHME) GBD Compare. Seattle: IHME, University of Washington; 2015.
    1. Anderson P, Chisholm D, Fuhr DC. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet. 2009;373(9682):2234–2246. doi: 10.1016/S0140-6736(09)60744-3. - DOI - PubMed
    1. Kohn R, Saxena S, Levav I, Saraceno B. The treatment gap in mental health care. Bull World Health Organ. 2004;82(11):858–866. - PMC - PubMed
    1. Socialdepartementet . [The Swedish Abuse Investigation]. Missbruket, Kunskapen, Vården (SOU 2011:6). Missbruksutredningens forskningsbilaga Offentliga Förlaget. 2011.
    1. Grant BF, Goldstein RB, Saha TD, Chou SP, Jung J, Zhang H, Pickering RP, Ruan WJ, Smith SM, Huang B, et al. Epidemiology of DSM-5 alcohol use disorder: results from the National Epidemiologic Survey on alcohol and related conditions III. JAMA Psychiat. 2015;72(8):757–766. doi: 10.1001/jamapsychiatry.2015.0584. - DOI - PMC - PubMed

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