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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Jan 26, 2021
Date Accepted: Apr 3, 2021

The final, peer-reviewed published version of this preprint can be found here:

CANreduce 2.0 Adherence-Focused Guidance for Internet Self-Help Among Cannabis Users: Three-Arm Randomized Controlled Trial

Baumgartner C, Schaub MP, Wenger A, Malischnig D, Augsburger M, Walter M, Berger T, Stark L, Ebert DD, Keough MT, Haug S

CANreduce 2.0 Adherence-Focused Guidance for Internet Self-Help Among Cannabis Users: Three-Arm Randomized Controlled Trial

J Med Internet Res 2021;23(4):e27463

DOI: 10.2196/27463

PMID: 33929333

PMCID: 8122293

CANreduce 2.0 – the effects of adherence-focused guidance for Internet self-help among cannabis misusers: results of a three-arm randomized controlled trial

  • Christian Baumgartner; 
  • Michael Patrick Schaub; 
  • Andreas Wenger; 
  • Doris Malischnig; 
  • Mareike Augsburger; 
  • Marc Walter; 
  • Thomas Berger; 
  • Lars Stark; 
  • David Daniel Ebert; 
  • Matthew T Keough; 
  • Severin Haug

ABSTRACT

Background:

Despite increasing demand for treatment among cannabis misusers in many countries, most misusers are not in treatment. Internet-based self-help offers an alternative for those hesitant to seek face-to-face therapy, though low-effectiveness and adherence issues often arise. Through adherence-focused guidance enhancement (AFGE), we aimed to increase adherence to, and the effectiveness of Internet-based self-help among cannabis misusers.

Objective:

A three-arm randomized controlled trial was conducted comparing the effectiveness of (1) an AFGE Internet-based self-help intervention with social presence (AFGE-SP), (2) a similar intervention with an impersonal service team (AFGE-ST), and (3) Internet access as usual (IAU, controls).

Methods:

From July 2016—May 2019, 575 cannabis misusers (70.6% males, mean age=28.3) not otherwise in treatment were recruited from the general population. The primary outcome was cannabis-use days over the preceding 30 days. Secondary outcomes included cannabis-dependence severity, changes in cannabis misuse disorder (CMD) symptoms, and intervention adherence.

Results:

All groups exhibited reduced cannabis-use days after 3 months (AFGE-SP: -8.2; AFGE-ST: -9.8; IAU: -4.2). AFGE-ST participants reported significantly fewer cannabis-use days than IAU controls (P = .01, d = .60); a similar reduction in the AFGE-SP (d=.40) group failed to achieve significance (P =.07). There was no significant difference between the two intervention groups. AFGE-ST patients also exhibited superior improvements in cannabis-use disorder, cannabis-dependence severity, and general anxiety symptoms after three months.

Conclusions:

Adding an impersonal service team to the AFGE Internet-based self-help intervention significantly reduced cannabis use, cannabis use disorder, dependence severity, and general anxiety symptoms. Clinical Trial: http://www.isrctn.com/ISRCTN11086185


 Citation

Please cite as:

Baumgartner C, Schaub MP, Wenger A, Malischnig D, Augsburger M, Walter M, Berger T, Stark L, Ebert DD, Keough MT, Haug S

CANreduce 2.0 Adherence-Focused Guidance for Internet Self-Help Among Cannabis Users: Three-Arm Randomized Controlled Trial

J Med Internet Res 2021;23(4):e27463

DOI: 10.2196/27463

PMID: 33929333

PMCID: 8122293

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