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. 2024 Sep 14;7(1):248.
doi: 10.1038/s41746-024-01241-2.

A randomized trial testing digital medicine support models for mild-to-moderate alcohol use disorder

Andrew Quanbeck  1 , Ming-Yuan Chih  2 , Linda Park  3 , Xiang Li  3 , Qiang Xie  3 , Alice Pulvermacher  3 , Samantha Voelker  3 , Rachel Lundwall  3 , Katherine Eby  4 , Bruce Barrett  3 , Randall Brown  3
Affiliations

A randomized trial testing digital medicine support models for mild-to-moderate alcohol use disorder

Andrew Quanbeck et al. NPJ Digit Med. .

Abstract

This paper reports the results of a hybrid effectiveness-implementation randomized trial that systematically varied levels of human oversight required to support the implementation of a digital medicine intervention for persons with mild-to-moderate alcohol use disorder (AUD). Participants were randomly assigned to three groups representing possible digital health support models within a health system: self-monitored use (SM; n = 185), peer-supported use (PS; n = 186), or a clinically integrated model CI; (n = 187). Across all three groups, the percentage of self-reported heavy drinking days dropped from 38.4% at baseline (95% CI [35.8%, 41%]) to 22.5% (19.5%, 25.5%) at 12 months. The clinically integrated group showed significant improvements in mental health and quality of life compared to the self-monitoring group (p = 0.011). However, higher attrition rates in the clinically integrated group warrant consideration in interpreting this result. Results suggest that making a self-guided digital intervention available to patients may be a viable option for health systems looking to promote alcohol risk reduction. This study was prospectively registered at clinicaltrials.gov on 7/03/2019 (NCT04011644).

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Conflict of interest statement

A.Q. has a shareholder interest in CHESS Health, a company that disseminates software technology to the addiction treatment field (CHESS Health did not develop the app tested in the manuscript). A.Q. also consults on the implementation of evidence-based healthcare interventions for the non-profit NIATx Foundation. These relationships are managed by the University of Wisconsin–Madison’s Conflict of Interest Committee. The remaining authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Study flow diagram.
The study flow diagram shows the number of participants from the initial screening to randomization through completion of follow-up surveys. Participants who contacted the research team to dropout of the study: SM = 0, PS = 1, CI = 9.
Fig. 2
Fig. 2. Percentage of weekly Tula users over time.
Illustrates the percentage of Tula users each week during the 52-week (or 12-month) study period. The numerators are the number of participants who used the Tula app in a particular study week while the denominators are the number of participants actively enrolled in the study during that week.
Fig. 3
Fig. 3. Primary outcomes over time.
Presents the group means of the primary outcomes over time (percentage of heavy drinking days, quality of life-physical health, and quality of life-mental health). The primary outcomes were collected in quarterly surveys at 0, 3, 6, 9, and 12 months after randomization.
Fig. 4
Fig. 4. Study groups.
The three study groups are listed in the columns, and their unique properties are compared in the rows.
See this image and copyright information in PMC

Update of

References

    1. Centers for Disease Control and Prevention. Data on excessive drinking. https://www.cdc.gov/alcohol/data-stats.htm#:~:text=According%20to%20the%... (2022).
    1. Centers for Disease Control and Prevention. Behavioral risk factor surveillance system survey data. https://www.cdc.gov/brfss/index.html (2022).
    1. Spillane, S. et al. Trends in alcohol-induced deaths in the United States, 2000–2016. JAMA Netw. Open3, e1921451 (2020). 10.1001/jamanetworkopen.2019.21451 - DOI - PMC - PubMed
    1. Bertha, M., Shedden, K. & Mellinger, J. Trends in the inpatient burden of alcohol‐related liver disease among women hospitalized in the United States. Liver Int.42, 1557–1561 (2022). 10.1111/liv.15277 - DOI - PMC - PubMed
    1. Miller, A. P. et al. Diagnostic criteria for identifying individuals at high risk of progression from mild or moderate to severe alcohol use disorder. JAMA Netw. Open6, e2337192 (2023). 10.1001/jamanetworkopen.2023.37192 - DOI - PMC - PubMed

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