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

Andrew Quanbeck; Ming Yuan Chih; Linda Park; Xiang Li; Qiang Xie; Alice Pulvermacher; Samantha Voelker; Rachel Lundwall; Katherine Eby; Bruce Barrett; Randall Brown

doi:10.1038/s41746-024-01241-2

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

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

Research output: Contribution to journal › Article › peer-review

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).

Original language	English
Article number	248
Journal	npj Digital Medicine
Volume	7
Issue number	1
DOIs	https://doi.org/10.1038/s41746-024-01241-2
State	Published - Dec 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

Funding

This research was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) grant number R01-AA024150. The funder had no role in any aspect of the development, conduct, analysis, or reporting of the study. The authors wish to thank our community partners: Safe Community of Madison and Dane County and the UW Health Wellness Center. In particular, we want to recognize Tanya Kraege, Charlestine “Charlie” Daniel, Cheryl Wittke, and the peer support specialists who were integral to moderating and facilitating discussion forums with participants in this study. We also want to recognize Diane Scherschel, the Integrative Health and Wellness Manager at the UW Health Wellness Center, as well as Katie Eby and Ellen Houston, who provided health coaching to our participants on their journey towards a healthier lifestyle. This project could not have succeeded without all their dedication and support. We thank Dave Gustafson Sr., Dave Gustafson Jr., and Adam Maus of the UW Center for Health Enhancement Systems Studies for their creation of the Tula app and technical support throughout the project. Lastly, we recognize the talents, efforts, and commitment of additional research team members towards this project: A.P., N.J., and S.V.

Funders	Funder number
UW Health Wellness Center
National Institute on Alcohol Abuse and Alcoholism	R01-AA024150

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

ASJC Scopus subject areas

Medicine (miscellaneous)
Health Informatics
Computer Science Applications
Health Information Management

Access to Document

10.1038/s41746-024-01241-2

Cite this

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

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

Abstract

Bibliographical note

Funding

UN SDGs

ASJC Scopus subject areas

Access to Document

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