Treatment-As-Usual Control Groups in Brief Alcohol Intervention Trials: ASystematic 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 TAUcontrol arms within reports of randomized controlled trials and examined whether treatment effects were affected by level ofdetail in narrative descriptions. Method: Asystematicliteraturesearch 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 ofclarity and detail included in descriptions of the intervention and TAUconditions 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 significantlyassociatedwithlargertreatment effects on drinksper week and alcohol consequences but were not significant for heavy drinking episodes. Conclusions: This meta-analysis reiterated the effectiveness of BAIs in medical settings. Yetthe lack of clarity in TAUdescriptions raises concerns regarding the validity of BAI trials, suggesting need for more detailed reporting and use of the TIDieR guidelinesfor support.