SALT LAKE CITY — What is the most effective psychosocial approach for harmful alcohol use?
A new study sought to determine that. Noting that psychosocial approaches are “the hallmark of treatment for harmful alcohol use,” the report in the journal Addiction added, “We aimed to compare the effectiveness of psychosocial therapy for harmful alcohol use using a network meta-analysis approach.”1
To do that, the study team led by researchers from the University of Utah and the VA Salt Lake City Healthcare System searched PubMed, Embase, CENTRAL, CINAHL and ProQuest Dissertations & Theses from inception to January 2022. Included in the analysis were randomized controlled trials in adults with harmful alcohol use. Ultimately, 4,225 records were retrieved from searching, with 19 involving 7,149 participants meeting the inclusion criteria.
The authors found that the most common heme, Intensity, and Provider/Platform (TIP) framework combination was brief interventions delivered once via face-to-face sessions (6 studies) and 11 TIP features were included in the network meta-analysis. They also determined that a significant difference in the Alcohol Use Disorder Identification Test (AUDIT) score was evident among 16 out of 55 treatment comparisons, with the highest effect size observed when motivational interviewing plus cognitive behavioral therapy in multiple sessions via face-to-face (MI-CBT/Mult/F2F) was compared with usual care (MD: -4.98; 95% confidence interval [CI]: -7.04, -2.91).
“This finding was consistent with [Surface under the cumulative ranking curve (SUCRA) methods], which suggested that MI-CBT/Mult/F2F is most likely to be better than other interventions (SUCRA=91.3),” the researchers wrote. “ MI-CBT/Mult/F2F remained the highest-ranking intervention in our sensitivity analyses (SUCRA=64.9, 80.8). However, the certainty of evidence for most treatment comparisons was low.”
The study concluded that “combined psychosocial intervention with more intensive approach may provide greater effect in reducing harmful alcohol consumption behavior”.
- Tan CJ, Shufelt T, Behan E, Jantara J, Koomsri et al. Comparative effectiveness of psychosocial interventions in adults with harmful use of alcohol: A systematic review and network meta-analysis. Addiction. 2023 Mar 11. doi: 10.1111/add.16187. Epub ahead of print. PMID: 36905310.
