Is motivational interviewing effective at reducing alcohol misuse in young adults? A critical review of Foxcroft et al. (2014).

Abstract

Foxcroft, Coombes, Wood, Allen, and Almeida Santimano (2014) recently conducted a meta-analysis evaluating the effectiveness of motivational interviewing (MI) in reducing alcohol misuse for youth up to age 25. They concluded that the overall effect sizes of MI in this population were too small to be clinically meaningful. The present paper critically reviews the Foxcroft et al. meta-analysis, highlighting weaknesses, such as problems with search strategies, flawed screening and reviews of full-text articles, incorrect data abstraction and coding, and, accordingly, improper effect size estimation. In addition, between-study heterogeneity and complex data structures were not thoughtfully considered or handled using best practices for meta-analysis. These limitations undermine the reported estimates and broad conclusion made by Foxcroft et al. about the lack of MI effectiveness for youth. We call for new evidence on this question from better-executed studies by independent researchers. Meta-analysis has many important utilities for translational research. When implemented well, the overall effectiveness as well as different effectiveness for different populations can be examined via meta-analysis. Emerging methods utilizing individual participant-level data, such as integrative data analysis, may be particularly helpful for identifying the sources of clinical and methodological heterogeneity that matter. The need to better understand the mechanisms of alcohol interventions has never been louder in the addiction field. Through more concerted efforts throughout all phases of generating evidence, we may achieve large-scale evidence that is efficient and robust and provides critical answers for the field.

Ecological Momentary Assessment of Alcohol Consumption and Its Concordance with Transdermal Alcohol Detection and Timeline Follow‐Back Self‐report Among Adults Experiencing Homelessness

“…Accurately assessing alcohol use via objective biosensors remains an important goal, especially for randomized clinical trials for alcohol misuse. Although self-reported outcomes will likely continue to be an important part of patient-oriented clinical outcomes research, it can be problematic when there are no objective outcome measures to interpret these self-reports (see Mun et al, 2015 for an example). Existing biosensors, although highly promising, have room to improve in terms of cost, functionality, and durability for use in clinical trials.…”

Do Brief Alcohol Interventions Reduce Driving After Drinking Among College Students? A Two-step Meta-analysis of Individual Participant Data

“…With the proliferation, the concern about low-quality or redundant meta-analysis reviews has also surfaced ( Ioannidis, 2016 ). The field of BAIs has not been an exception as we have previously discussed ( Mun et al. , 2015a ).…”

Back to basics

“…The Cochrane review on motivational interviewing (MI) for alcohol misuse in young adults [1] has raised some controversy previously [2]. In their paper, Grant et al [3] add to the controversy and, while I agree with most of the views they put forward, I would like to raise points on a couple of different aspects that deserve particular attention.…”