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Unguided Chatbot-Delivered Cognitive Behavioural Intervention for Problem Gamblers Through Messaging App: A Randomised Controlled Trial

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Abstract

Internet-delivered intervention may be an acceptable alternative for the more than 90% of problem gamblers who are reluctant to seek face-to-face support. Thus, we aimed to (1) develop a low-dropout unguided intervention named GAMBOT integrated with a messaging app; and (2) investigate its effect. The present study was a randomised, quadruple-blind, controlled trial. We set pre-to-post change in the Problem Gambling Severity Index (PGSI) as the primary outcome and pre-to-post change in the Gambling Symptom Assessment Scale (G-SAS) as a secondary outcome. Daily monitoring, personalised feedback, and private messages based on cognitive behavioural theory were offered to participants in the intervention group through a messaging app for 28 days (GAMBOT). Participants in the control group received biweekly messages only for assessments for 28 days (assessments only). A total of 197 problem gamblers were included in the primary analysis. We failed to demonstrate a significant between-group difference in the primary outcome (PGSI − 1.14, 95% CI − 2.75 to 0.47, p = 0.162) but in the secondary outcome (G-SAS − 3.14, 95% CI − 0.24 to − 6.04, p = 0.03). Only 6.7% of the participants dropped out during follow-up and 77% of the GAMBOT group participants (74/96) continued to participate in the intervention throughout the 28-day period. Integrating intervention into a chatbot feature on a frequently used messaging app shows promise in helping to overcome the high dropout rate of unguided internet-delivered interventions. More effective and sophisticated contents delivered by a chatbot should be sought to engage over 90% of problem gamblers who are reluctant to seek face-to-face support.

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Acknowledgements

We would like to thank E. Kamimura and K. Yokomitsu for providing the Japanese version of G-SAS with us. We also thank R. Fujioka and A. Muraida for helping coordination of the present study.

Funding

This trial was funded by the Japan Agency for Medical Research and Development (AMED). AMED had no role in any process of the study from development of the intervention to writing the manuscript.

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Authors and Affiliations

Authors

Contributions

SH is the principal investigator and is responsible for the study process. SH, RS, TAF, and TB developed the study protocol. RS, SM, TM, SF, HO, and SH contributed to developing the intervention. RS designed the system for randomization and the data collection system. TAF performed the statistical analysis for the primary and secondary outcomes. RS aggregated the usage data. SH, RS, and TAF drafted the manuscript. SM and SH acquired the funding. All authors reviewed and edited the manuscript and approved the final version.

Corresponding author

Correspondence to Ryuhei So.

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Conflict of interest

RS, SM, TM, SF, HO, and SH had been involved in the development of the workbook for face-to-face group CBT for Gambling Disorder on which the content of GAMBOT was based. GAMBOT was mainly developed by RS referring to the workbook. Both the workbook and GAMBOT were developed not for business but for academic interest. RS has received personal fees from Igaku-shoin Co., Ltd., Kagaku-hyoronsha Co., Ltd., Medical Review Co., Ltd., Otsuka Pharmaceutical Co., Ltd., and CureApp Inc. outside the submitted work. TAF reports personal fees from Meiji, grants and personal fees from Mitsubishi-Tanabe, personal fees from MSD, personal fees from Pfizer, outside the submitted work; TAF has a patent 2018-177688 pending. SH, TM, SF, HO, and TB declared no conflict of interest. The authors have received national funding from the Japan Agency for Medical Research and Development (AMED).

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So, R., Furukawa, T.A., Matsushita, S. et al. Unguided Chatbot-Delivered Cognitive Behavioural Intervention for Problem Gamblers Through Messaging App: A Randomised Controlled Trial. J Gambl Stud 36, 1391–1407 (2020). https://doi.org/10.1007/s10899-020-09935-4

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  • DOI: https://doi.org/10.1007/s10899-020-09935-4

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