PMID- 34859519
OWN - NLM
STAT- MEDLINE
DCOM- 20220405
LR  - 20231027
IS  - 1360-0443 (Electronic)
IS  - 0965-2140 (Print)
IS  - 0965-2140 (Linking)
VI  - 117
IP  - 5
DP  - 2022 May
TI  - Efficacy and comparative effectiveness of telephone and smartphone remote 
      continuing care interventions for alcohol use disorder: a randomized controlled 
      trial.
PG  - 1326-1337
LID - 10.1111/add.15771 [doi]
AB  - BACKGROUND AND AIMS: Management of alcohol use disorder (AUD) could be enhanced 
      by effective remote treatments. This study tested whether supplementing intensive 
      outpatient programs (IOPs) with continuing care delivered via (1) telephone, (2) 
      smartphone or (3) their combination improves outcomes relative to (4) IOP only. 
      Continuing care conditions were also compared. DESIGN: Randomized controlled 
      trial of four groups with 3-, 6-, 9-, 12- and 18-month follow-ups. SETTING: 
      University research center in Philadelphia, PA, USA. PARTICIPANTS: Participants 
      (n = 262) met DSM-V criteria for AUD, were largely male (71%) and African 
      American (82%). INTERVENTIONS AND COMPARATOR: Telephone monitoring and counseling 
      (TMC; n = 59), addiction comprehensive health enhancement support system (ACHESS; 
      n = 68) and TMC + ACHESS (n = 70) provided for 12 months. The control condition 
      received IOP only (TAU; n = 65). MEASUREMENT: The primary outcome was percentage 
      of days heavy drinking (PDHD) in months 1-12. Secondary outcomes were any 
      drinking, any drug use, drinking consequences and quality of life. FINDINGS: Mean 
      PDHD in months 1-12 was 10.29 in TAU, 5.41 in TMC, 6.80 in ACHESS and 5.99 in 
      TMC + ACHESS. PDHD was lower in TMC [Cohen's d = 0.35, P = 0.018, 95% confidence 
      interval (CI) = (-1.42, -0.20)], ACHESS [d = 0.31, P = 0.031, 95% CI = (-1.27, 
      -0.06)] and TMC + ACHESS [d = 0.36, P = 0.009, 95% CI = (-1.40, -0.20)] than in 
      TAU. Differences between TMC + ACHESS, TMC and ACHESS were small (d </= 0.06) and 
      non-significant. Findings were inconclusive as to whether or not the treatment 
      conditions differed on PDHD at 18 months. A significant effect was obtained on 
      any drinking, which was higher in months 1-12 in TAU than in TMC [odds ratio 
      (OR) = 3.02, standard error (SE) = 0.43, 95% CI = (1.30, 6.99), P = 0.01] and 
      TMC + ACHESS [OR = 2.43, SE = 0.39, 95% CI = (1.12, 5.27), P = 0.025). No other 
      significant effects were obtained on other secondary outcomes during or after 
      treatment. CONCLUSIONS: A telephone-delivered intervention and a 
      smartphone-delivered intervention, alone and in combination, provided effective 
      remote continuing care for alcohol use disorder. The combination of both 
      interventions was not superior to either alone and effects did not persist 
      post-treatment.
CI  - (c) 2021 Society for the Study of Addiction.
FAU - McKay, James R
AU  - McKay JR
AUID- ORCID: 0000-0001-5876-1687
AD  - Center for Studies of Addiction, Perelman School of Medicine. University of 
      Pennsylvania, Philadelphia, PA, USA.
AD  - Crescenz VAMC, Philadelphia, PA, USA.
FAU - Gustafson, David H
AU  - Gustafson DH
AUID- ORCID: 0000-0002-0660-1902
AD  - Center for Health Enhancement System Studies, University of Wisconsin-Madison, 
      Madison, WI, USA.
FAU - Ivey, Megan
AU  - Ivey M
AD  - Center for Studies of Addiction, Perelman School of Medicine. University of 
      Pennsylvania, Philadelphia, PA, USA.
FAU - Pe-Romashko, Klaren
AU  - Pe-Romashko K
AUID- ORCID: 0000-0002-5208-0458
AD  - Center for Health Enhancement System Studies, University of Wisconsin-Madison, 
      Madison, WI, USA.
FAU - Curtis, Brenda
AU  - Curtis B
AUID- ORCID: 0000-0002-2511-3322
AD  - Technology and Translational Research Unit, National Institute on Drug Abuse, 
      National Institute of Health, Biomedical Research Center, Baltimore, MD.
FAU - Thomas, Tyrone
AU  - Thomas T
AD  - Center for Studies of Addiction, Perelman School of Medicine. University of 
      Pennsylvania, Philadelphia, PA, USA.
FAU - Oslin, David W
AU  - Oslin DW
AUID- ORCID: 0000-0003-4392-4599
AD  - Center for Studies of Addiction, Perelman School of Medicine. University of 
      Pennsylvania, Philadelphia, PA, USA.
AD  - Crescenz VAMC, Philadelphia, PA, USA.
FAU - Polsky, Daniel
AU  - Polsky D
AUID- ORCID: 0000-0001-8403-9612
AD  - Department of Health Policy and Management, Bloomberg School of Public Health, 
      Carey Business School, Johns Hopkins University, Baltimore, MD, USA.
FAU - Quanbeck, Andrew
AU  - Quanbeck A
AUID- ORCID: 0000-0003-0762-4804
AD  - Department of Family Medicine and Community Health, University of 
      Wisconsin-Madison, Madison, WI, USA.
FAU - Lynch, Kevin G
AU  - Lynch KG
AUID- ORCID: 0000-0002-0426-0323
AD  - Center for Studies of Addiction, Perelman School of Medicine. University of 
      Pennsylvania, Philadelphia, PA, USA.
AD  - Crescenz VAMC, Philadelphia, PA, USA.
LA  - eng
SI  - ClinicalTrials.gov/NCT02681406
GR  - R01 AA022595/AA/NIAAA NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
DEP - 20211223
PL  - England
TA  - Addiction
JT  - Addiction (Abingdon, England)
JID - 9304118
SB  - IM
MH  - Alcohol Drinking/therapy
MH  - *Alcoholism/psychology/therapy
MH  - Humans
MH  - Male
MH  - Quality of Life
MH  - Smartphone
MH  - Telephone
PMC - PMC10600977
MID - NIHMS1934523
OTO - NOTNLM
OT  - Alcohol use disorder
OT  - continuing care
OT  - outcome
OT  - smartphone
OT  - telephone
OT  - treatment
COIS- Declarations of competing interests: Drs. Gustafson and Quanbeck have shareholder 
      interest in CHESS Health, a public benefit corporation that disseminates 
      technology-based health care interventions for patients and family members 
      struggling with addiction. This relationship is extensively managed by the author 
      and the University of Wisconsin-Madison's Conflict of Interest Committee. No 
      other disclosures were reported.
EDAT- 2021/12/04 06:00
MHDA- 2022/04/06 06:00
PMCR- 2023/10/26
CRDT- 2021/12/03 07:26
PHST- 2021/02/22 00:00 [received]
PHST- 2021/11/05 00:00 [accepted]
PHST- 2021/12/04 06:00 [pubmed]
PHST- 2022/04/06 06:00 [medline]
PHST- 2021/12/03 07:26 [entrez]
PHST- 2023/10/26 00:00 [pmc-release]
AID - 10.1111/add.15771 [doi]
PST - ppublish
SO  - Addiction. 2022 May;117(5):1326-1337. doi: 10.1111/add.15771. Epub 2021 Dec 23.