J. Med. Internet Res. - Effectiveness of a self-guided web-based cannabis treatment program: randomized controlled trial.


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CKGROUND: Self-help strategies offer a promising way to address problems with access to and stigma associated with face-to-face drug and alcohol treatment, and the Internet provides an excellent delivery mode for such strategies. To date, no study has tested the effectiveness of a fully self-guided web-based treatment for cannabis use and related problems.OBJECTIVES: The current study was a two-armed randomized controlled trial aimed at testing the effectiveness of Reduce Your Use, a fully self-guided web-based treatment program for cannabis use disorder consisting of 6 modules based on cognitive, motivational, and behavioral principles.METHODS: 225 individuals who wanted to cease or reduce their cannabis use were recruited using both online and offline advertising methods and were randomly assigned to receive: (1) the web-based intervention, or (2) a control condition consisting of 6 modules of web-based educational information on cannabis. Assessments of cannabis use, dependence symptoms, and abuse symptoms were conducted through online questionnaires at baseline, and at 6-week and 3-month follow-ups. Two sets of data analyses were undertaken--complier average causal effect (CACE) modeling and intention to treat (ITT).RESULTS: Two thirds (149) of the participants completed the 6-week postintervention assessment, while 122 (54%) completed the 3-month follow-up assessment. Participants in the intervention group completed an average of 3.5 of the 6 modules. The CACE analysis revealed that at 6 weeks, the experimental group reported significantly fewer days of cannabis use during the past month (P=.02), significantly lower past-month quantity of cannabis use (P=.01), and significantly fewer symptoms of cannabis abuse (P=.047) relative to controls. Cannabis dependence symptoms (number and severity) and past-month abstinence did not differ significantly between groups (Ps>.05). Findings at 3 months were similar, except that the experimental group reported significantly fewer and less severe cannabis dependence symptoms (Ps<.05), and past-month quantity of cannabis consumed no longer differed significantly between groups (P=.16). ITT analyses yielded similar outcomes.CONCLUSION: Findings suggest that web-based interventions may be an effective means of treating uncomplicated cannabis use and related problems and reducing the public health burden of cannabis use disorders.TRIAL REGISTRATION: ACTRN12609000856213, Australian New Zealand Clinical Trials Registry.

Resumo Limpo

ckground selfhelp strategi offer promis way address problem access stigma associ facetofac drug alcohol treatment internet provid excel deliveri mode strategi date studi test effect fulli selfguid webbas treatment cannabi use relat problemsobject current studi twoarm random control trial aim test effect reduc use fulli selfguid webbas treatment program cannabi use disord consist modul base cognit motiv behavior principlesmethod individu want ceas reduc cannabi use recruit use onlin offlin advertis method random assign receiv webbas intervent control condit consist modul webbas educ inform cannabi assess cannabi use depend symptom abus symptom conduct onlin questionnair baselin week month followup two set data analys undertakencompli averag causal effect cace model intent treat ittresult two third particip complet week postintervent assess complet month followup assess particip intervent group complet averag modul cace analysi reveal week experiment group report signific fewer day cannabi use past month p signific lower pastmonth quantiti cannabi use p signific fewer symptom cannabi abus p relat control cannabi depend symptom number sever pastmonth abstin differ signific group ps find month similar except experiment group report signific fewer less sever cannabi depend symptom ps pastmonth quantiti cannabi consum longer differ signific group p itt analys yield similar outcomesconclus find suggest webbas intervent may effect mean treat uncompl cannabi use relat problem reduc public health burden cannabi use disorderstri registr actrn australian new zealand clinic trial registri

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