Digital Interventions for Subclinical and Clinical Alcohol Use Disorders with or without Co-Occurring Psychiatric Conditions: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials

This umbrella review synthesized findings from 21 systematic reviews of randomized controlled trials (k = 189, n = 116,618) examining the effectiveness of digital interventions (DIs) in reducing alcohol consumption among individuals with problematic alcohol use. Effects were analysed across population type (clinical vs subclinical), intervention intensity (high vs low), format (guided vs unguided), delivery mode (app vs computer), comparator (passive vs active), and follow-up duration (short-vs long-term). Small but consistent short-term effects were found for clinical populations, high-intensity interventions, and guided and unguided formats. App-based interventions showed strongest effects, though outcomes were comparable across delivery modes. Unguided DIs showed comparable effects to guided interventions. DIs outperformed passive controls and, in some analyses, face-to-face interventions. Most effects were confined to short-term follow-up. Certainty of evidence ranged from very low to moderate, with downgrades due to risk of bias, inconsistency, imprecision, and publication bias. Future research should prioritize rigor, standardization, and long-term outcomes. PROSPERO: CRD42024531674.