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

Area of Science:

• Behavioral Health
• Digital Health Interventions
• Substance Use Disorder Treatment

Background:

• Brief interventions (BIs) are effective for drug misuse but often limited by staff capacity.
• Computerized BIs (CBI) offer a scalable solution, yet direct comparisons with in-person BIs (IBI) are lacking.

Purpose of the Study:

• To compare the effectiveness of CBI versus IBI for moderate drug use in primary care.
• To evaluate patient outcomes using standardized screening tools and drug testing.

Main Methods:

• A two-arm randomized clinical trial involving 360 primary care patients with moderate drug use scores.
• Participants were assigned to either CBI or IBI delivered by a behavioral health counselor.
• Assessments included the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and hair drug testing at baseline and 3-month follow-up.

Main Results:

• No significant differences were found between CBI and IBI in global ASSIST scores or drug-positive hair tests at 3 months.
• CBI showed a statistically significant advantage over IBI in reducing marijuana and cocaine use, as indicated by substance-specific ASSIST scores.
• Effect sizes for marijuana and cocaine favored CBI, suggesting targeted benefits.

Conclusions:

• Computerized brief intervention (CBI) is a viable and effective alternative to in-person brief intervention (IBI) for moderate drug use in primary care settings.
• CBI may offer specific advantages for certain substances like marijuana and cocaine.
• The findings support the integration of digital health tools to address behavioral health needs in primary care.