|Titre :||Reviewing and interpreting the effects of brief alcohol interventions: comment on a Cochrane review about motivational interviewing for young adults [For debate] (2016)|
|Auteurs :||S. GRANT ; E. R. PEDERSEN ; K. C. OSILLA ; M. KULESZA ; E. J. D'AMICO|
|Type de document :||Article : Périodique|
|Dans :||Addiction (Vol.111, n°9, September 2016)|
|Article en page(s) :||1521-1527|
|Note générale :||
Refers to: Foxcroft D.R., Coombes L., Wood S., Allen D. et Almeida Santimano N.M., Motivational interviewing for alcohol misuse in young adults, Cochrane Database of Systematic Reviews, n°8, 2014, CD007025.
- Is it time to define minimally clinically important differences for patient-reported outcome measures used in alcohol brief intervention studies? Newton A.S., Wild C.T., p. 1528-1529.
- Back to basics. Gual A., p. 1529-1530.
- Is it time for a more ambitious research agenda for decreasing alcohol-related harm among young adults? Bradley K.A., Lapham G.T., p. 1531-1532.
- We cannot ignore bias, especially if effects are small, but we need better methods for evaluating prevention systems. Foxcroft D.R., p. 1532-1533.
- It is time to develop appropriate tools for assessing minimal clinically important differences, performance bias and quality of evidence in reviews of behavioral interventions. Grant S., Pedersen E.R., Osilla K.C., Kulesza M., D'Amico E.J., p. 1533-1535.
|Discipline :||TRA (Traitement et prise en charge / Treatment and care)|
Thésaurus TOXIBASEALCOOL ; ENTRETIEN MOTIVATIONNEL ; INTERVENTION BREVE ; MOTIVATION ; METHODE ; QUALITE ; ADULTE JEUNE
Background: Cochrane recently published a systematic review on motivational interviewing (MI) for alcohol misuse in young adults. The review authors concluded that 'there are no substantive, meaningful benefits of MI interventions for the prevention of alcohol misuse' (p. 2), as effect sizes were 'small and unlikely to be of any meaningful benefit in practice’ (p. 27). As most of these interventions were quite brief, we wish to open a dialogue about interpreting effect sizes in this review and of (brief) alcohol interventions more generally.
Analysis: We analyze four methodological aspects of the review that likely influenced the author's conclusions about intervention effects: (1) risk of bias assessments, (2) search strategies, (3) assessing the quality of the body of evidence and (4) definitions of sustainability and clinical significance.
Conclusions: We interpret the effect sizes found in this review to indicate modest yet beneficial and potentially meaningful effects of these interventions, given their brevity and low cost. This interpretation is consistent with other reviews on brief, MI-based interventions and brief interventions more generally. We therefore encourage the field to re-open dialogue about the clinical importance of the effects of MI on alcohol misuse by young adults. Rather than dismissing interventions with small effects, we believe a more fruitful way forward for the field would be to catalogue effect sizes for various alcohol interventions. Such a catalogue would help stakeholders themselves to choose which interventions meet their minimum desired impact, and thus may be suitable given their targeted populations, setting and resources.
|Domaine :||Alcool / Alcohol|
|Refs biblio. :||56|
|Affiliation :||RAND Corporation, Santa Monica, CA, USA|