Treatment-As-Usual Control Groups in Brief Alcohol Intervention Trials: A Systematic Review and Meta-Analysis

Objective: Brief alcohol interventions (BAIs) are evi-dence-based practices that can help reduce hazardous drinking among patients in medical settings. However, descriptions of the treatment-as -usual (TAU) control groups that BAIs are compared to in clinical trials often lack clarity and detail. This systematic review and meta-analysis quantified and compared descriptions of intervention and TAU control arms within reports of randomized controlled trials and examined whether treatment effects were affected by level of detail in narrative descriptions. Method: A systematic literature search to identify eligible articles was performed. Studies were rated on methodological quality, and the Template for Intervention Description and Replication (TIDieR) checklist was used to rate the level of clarity and detail included in descriptions of the intervention and TAU conditions in eligible articles. Data were extracted from articles for use in meta-analysis and meta -regression. Results: Twenty-one studies met inclusion criteria. Across the studies, TIDieR ratings for intervention arms were higher than ratings for control arms. BAIs were linked to reductions in drinks per week, heavy drinking episodes, and alcohol consequences over time when compared with TAU. TIDieR ratings for control groups were significantly associated with larger treatment effects on drinks per week and alcohol consequences but were not significant for heavy drinking episodes. Conclusions: This meta-analysis reiterated the effectiveness of BAIs in medical settings. Yet the lack of clarity in TAU descriptions raises concerns regarding the validity of BAI trials, suggesting need for more detailed reporting and use of the TIDieR guidelines for support. (J. Stud. Alcohol Drugs, 83, 934-943, 2022)

Automated summary

This study conducted a systematic review and meta-analysis to examine the descriptions of interventions and treatment-as-usual (TAU) control groups in randomized controlled trials, and to assess the impact of the level of detail on treatment effects. The findings demonstrated the effectiveness of brief alcohol interventions in medical settings. However, the lack of clarity in the descriptions of TAU raises concerns about the validity of the trials, emphasizing the need for more detailed reporting and the use of TIDieR guidelines.