Computerized versus in‐person brief intervention for drug misuse: a randomized clinical trial

AbstractBackground and AimsSeveral studies have found that brief interventions (BIs) for drug misuse have superior effectiveness to no‐treatment controls. However, many health centers do not provide BIs for drug use consistently due to insufficient behavioral health staff capacity. Computerized BIs for drug use are a promising approach, but their effectiveness compared with in‐person BIs has not been established. This study compared the effectiveness of a computerized brief intervention (CBI) to an in‐person brief intervention (IBI) delivered by a behavioral health counselor.MethodsTwo‐arm randomized clinical trial, conducted in two health centers in New Mexico, United States. Participants were 360 adult primary care patients with moderate‐risk drug scores on the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) who were randomly assigned on a 1 : 1 basis to a computerized brief intervention (CBI) or to an in‐person brief intervention (IBI) delivered by a behavioral health counselor. Assessments were conducted at baseline and 3‐month follow‐up, and included the ASSIST and drug testing on hair samples.ResultsThe IBI and CBI conditions did not differ at 3 months on global ASSIST drug scores [b = −1.79; 95% confidence interval (CI) = −4.37, 0.80] or drug‐positive hair tests [odds ratio (OR) = 0.97; 95% CI = 0.47, 2.02]. There was a statistically significant advantage of CBI over IBI in substance‐specific ASSIST scores for marijuana (b = −1.73; 95% CI = −2.91, −0.55; Cohen's d = 0.26; P = 0.004) and cocaine (b = −4.48; 95% CI = −8.26, −0.71; Cohen's d = 0.50; P = 0.021) at 3 months.ConclusionsComputerized brief intervention can be an effective alternative to in‐person brief intervention for addressing moderate drug use in primary care.