Results of a randomized clinical trial published online Wednesday by JAMA Psychiatry showed that a “smartphone-based application could provide effective continuing care to patients with alcohol use disorders.” The study monitored 349 patients who entered and completed one of three residential treatment programs in the U.S. The patients were divided into two randomized groups. Both groups received treatment as usual, but one of the groups also received a smartphone that had the Addiction-Comprehensive Health Enhancement Support System (A-CHESS) application installed on it along with instructions on how to use the app.
Researchers then asked all study participants to record the number of “risky drinking days” they had. The study defined a risky drinking day as one in which men consumed over four standard drinks in a two-hour period. For women, the number was three. A standard drink was defined as either 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of distilled spirits. The study found that both during the 8-month intervention and 4-month follow-up periods, the group using A-CHESS “reported significantly fewer risky drinking days” than control-group patients did.
The abstract states that when patients in both groups were discharged from the treatment program, they were not offered coordinated continuing care, and it does not specify the definition of coordinated continuing care; however, it is highly unusual for a drug or alcohol residential treatment center to discharge a patient without having first worked out some type of an aftercare program for that patient. The study’s abstract also states that it is not typical to offer evidence-based continued care to patients who have finished a residential treatment program for alcohol use disorders. But it does not define or describe any type or types of continued care that are not evidenced-based. It is thus unclear if A-CHESS was being compared to the total absence of continued care or continued care that was not evidence-based as well as uncoordinated. Additionally, the abstract states that patients reported the number of risky drinking days in the 30-day period before the 4, 8, and 12-month marks after being discharged from treatment, yet the results state that risky drinking days numbers were lower only “for the 8 months of the intervention and 4 months of follow-up.” It is unclear whether or not the numbers were still lower than the control group’s 8 and 12 months after being discharged.
According to an article in Yahoo! News, scientist-administrator Daniel Falk of the National Institute on Alcohol Abuse and Alcoholism said that the A-CHESS results were similar to the statistics for those who go through standard follow-up counseling or take anti-addiction medication. Falk also said that 75 percent of the 18 million Americans who seek treatment for alcohol use disorders are unable to remain abstinent for at least one year after being discharged from treatment. Technology-based tools are being looked at to help lower that percentage.
According to the JAMA Psychiatry abstract, “A-CHESS provides monitoring, information, communication, and support services to patients, including ways for patients and counselors to stay in contact.” It is the immediacy of the app, say addiction experts, that makes it a useful relapse prevention tool. One patient who took part in the study, Mark Wiitala, called A-CHESS an “absolutely amazing tool” that helped save his life. He most appreciated the app’s ability to connect him to a network of peers who had gone through the same recovery program as he did. The app also has a panic button that, when activated, will send out a message to a previously-determined support system. The messages states that the person who pressed it is struggling and asks those who received the message to reach out to him or her. A-CHESS is not yet available to the public.
By Donna Westlund