Efficacy of a short-term webcam-based telemedicine treatment of internet use disorders (OMPRIS): a multicentre, prospective, single-blind, randomised, clinical trial

Jan Dieris-Hirche; Laura Bottel; Jale Basten; Magdalena Pape; Nina Timmesfeld; Bert Theodor Te Wildt; Birte Linny Geisler; Klaus Wölfling; Peter Henningsen; Manfred Beutel; Anja Neumann; Anja Niemann; Rainer Beckers; Stephan Herpertz; OMPRIS Study Group

doi:10.1016/j.eclinm.2023.102216

Efficacy of a short-term webcam-based telemedicine treatment of internet use disorders (OMPRIS): a multicentre, prospective, single-blind, randomised, clinical trial

EClinicalMedicine. 2023 Sep 14:64:102216. doi: 10.1016/j.eclinm.2023.102216. eCollection 2023 Oct.

Authors

Collaborators

OMPRIS Study Group:
Annika Best, Raffaela Böswald, Lorraine Cornelsen, Michael Dreier, Sofie Groen, Alicia Hemmersbach, Vivienne Hillerich, Ina Krahn, Dennis Lowin, Alicia Menze, Silke Neusser, Nehle Penning, Heribert Sattel, Christian Suelmann, Marianne Tokic, Julia Weretecki

Affiliations

¹ Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany.
² Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Universitätsstraße 105, 44789, Bochum, Germany.
³ Psychosomatic Hospital Diessen Monastery, Klosterhof 20, 86911, Diessen, Germany.
⁴ Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675 Munich, Germany.
⁵ Outpatient Clinic for Behavioral Addictions, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany.
⁶ Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
⁷ Competence Centre of Healthcare Telematics, Haus Harkorten 8, 58135, Hagen, Germany.

Abstract

Background: Evidence-based treatments for internet use disorders (IUDs) are limited, and online therapy approaches are poorly studied. We investigated the efficacy of a manualised therapist-guided online intervention (OMPRIS) to reduce IUD symptoms and improve psychological well-being.

Methods: In this multicentre, two-arm, single-blinded trial, individuals ≥16 years suffering from IUD symptoms were recruited in Germany from August 16, 2020, to March 11, 2022, through media advertisements and healthcare providers. Participants were randomly allocated by sequential balancing randomisation (1:1) to either the manualised webcam-based OMPRIS intervention or a waitlist control (WLC) group. OMPRIS provided strategies from motivational interviewing, behavioural therapy, and social counselling. The primary outcome at the end of treatment was a reduction in IUD symptoms as measured by the Assessment of Internet and Computer Scale (AICA-S). Follow-up assessments were conducted at 6 weeks and 6 months. Analyses were performed in the intention-to-treat population. This trial was registered (German Clinical Trial Register, DRKS00019925) and has been completed.

Findings: A total of 180 individuals were randomly assigned to the OMPRIS intervention (n = 89) or WLC (n = 91) arm. After treatment, 81 (91.0%) participants in the OMPRIS intervention group and 88 (96.7%) in the WLC group completed the outcome assessment. The ANCOVA model showed that OMPRIS participants had a significantly greater reduction in AICA-S scores from baseline (mean score 12.1 [SD 4.6]) to post-treatment (6.8 [5.2]) than those in the WLC group (from 12.6 [5.1] to 11.0 [5.4]; estimated mean difference -3.9; [95% CI -5.2 to -2.6]; p < 0.0001; d = 0.92). No adverse events were reported to the trial team.

Interpretation: Webcam-based OMPRIS therapy was effective and superior to waiting list conditions in reducing IUD symptoms. Webcam-based, specialised online therapy thus increases IUD treatment options.

Funding: German Innovation Fund of Germany's Federal Joint Committee (G-BA), grant number 01VSF18043.

Keywords: Gaming disorder; Internet addiction; Internet use disorder; Online therapy; Telemedicine; Treatment.