JMIR Publications

ABSTRACT

Background:

Primary care settings are uniquely positioned to reach individuals at-risk of alcohol use disorder through technology-delivered behavioral health interventions. Despite emerging effectiveness data, few efforts have been made to summarize the collective findings from these delivery approaches.

Objective:

The purpose of this study was to review recent literature on the use of technology to deliver, enhance, or support the implementation of alcohol-related interventions in primary care. We focused on addressing questions related to (1) categorization and target, (2) descriptive characteristics and context of delivery, (3) reported efficacy, and (4) factors influencing efficacy.

Methods:

We conducted a comprehensive search and systematic review of completed studies at the intersection of primary care, technology, and alcohol-related problems published from January 2000 to December 2018 within EBSCO databases, ProQuest Dissertations, and Cochrane Reviews. Of 2307 initial records, 42 were included and coded independently by two investigators.

Results:

Compared to the years of 2000-2009, published studies on technology-based alcohol interventions in primary care nearly tripled during the years of 2010-2018. Of the 42 studies, 28 (64%) were randomized controlled trials. Further, studies were rated on risk of bias and found to be predominantly low risk (n=18), followed by moderate risk (n=16), and high risk (n=8). The majority (71%) of studies reported reduced drinking or harm in all primary and secondary efficacy outcomes. Furthermore, 42% of studies reported that at least half of the primary and secondary efficacy outcomes of the technology-based interventions were superior to treatment as usual. High efficacy was associated with provider involvement and the reported use of an implementation strategy to deliver the technology-based intervention.

Conclusions:

Our systematic review highlights a pattern of growth in the number of studies evaluating technology-based alcohol interventions in primary care. While these interventions appear largely beneficial in primary care, outcomes may be enhanced by provider involvement and implementation strategy use. This review enables better understanding of the typologies and efficacy of these interventions and informs recommendations for those developing and implementing technology-based alcohol interventions in primary care settings.