A Mobile Phone App Featuring Cue Exposure Therapy As Aftercare for Alcohol Use Disorders: An Investigator-Blinded Randomized Controlled Trial

Abstract

Background Cue exposure therapy (CET) is a psychological approach developed to prepare individuals with alcohol use disorder (AUD) for confronting alcohol and associated stimuli in real life. CET has shown promise when treating AUD in group sessions, but it is unknown whether progressing from group sessions to using a mobile phone app is an effective delivery pathway. Objective The objectives of this study were to investigate (1) whether CET as aftercare would increase the effectiveness of primary treatment with cognitive behavior therapy, and (2) whether CET delivered through a mobile phone app would be similarly effective to CET via group sessions. Methods A total of 164 individuals with AUD were randomized to one of three groups: CET as group aftercare (CET group), CET as fully automated mobile phone app aftercare (CET app), or aftercare as usual. Study outcomes were assessed face-to-face at preaftercare, postaftercare, and again at 6 months after aftercare treatment. Generalized mixed models were used to compare the trajectories of the groups over time on drinking, cravings, and use of urge-specific coping skills (USCS). Results In all, 153 of 164 individuals (93%) completed assessments both at posttreatment and 6-month follow-up assessments. No differences in the trajectories of predicted means were found between the experimental groups (CET group and app) compared with aftercare as usual on drinking and craving outcomes over time. Both CET group (predicted mean difference 5.99, SE 2.59, z=2.31, P=.02) and the CET app (predicted mean difference 4.90, SE 2.26, z=2.31, P=.02) showed increased use of USCS compared to aftercare as usual at posttreatment, but this effect was reduced at the 6-month follow-up. No differences were detected between the two experimental CET groups on any outcomes. Conclusions CET with USCS delivered as aftercare either via group sessions or a mobile phone app did not increase the effectiveness of primary treatment. This suggests that CET with USCS may not be an effective psychological approach for the aftercare of individuals treated for AUD. Trial Registration ClinicalTrials.gov NCT02298751; https://clinicaltrials.gov/ct2/show/NCT02298751

Smartphone apps for managing alcohol consumption: a literature review

“…Of the seven apps for use among individuals with AUD there have been three RCTs. One found a significant reduction in 'risky drinking days' among participants using an app compared to controls given only treatment as usual (P = 0.003) [25], while the other two trials found no significant differences in any alcohol consumption outcomes between the intervention and control groups [29,32]. The other four trials in this population had mixed results, with three finding significant reductions in alcohol consumption measures and one finding no significant changes.…”

“…Of the 19 unique apps, seven were designed for use among youth [14][15][16][17][18][19][20][21] and 12 in adult populations [22][23][24][25][26][27][28][29][30][31][32][33][34]. The results of these studies are summarised in Table 1.…”

Leveraging mHealth and Wearable Sensors to Manage Alcohol Use Disorders: A Systematic Literature Review

“…Of the 25 studies, 14/25 (56%) used an mHealth app, 4/25 (16%) used telephone or interactive voice response, 3/25 (12%) used mHealth serious games or cognitive training delivered on mobile devices, and four studies used either mHealth SMS or mHealth + telephone (2/26 each, 8%). Of the 25 studies analyzed over a 10-year period, 2 were from 2012 [ 17 , 18 ], 1 was from 2013 [ 19 ], 2 were from 2014 [ 20 , 21 ], 1 was from 2015 [ 22 ], 3 were from 2016 [ 23 , 24 , 25 ], 4 were from 2017 [ 26 , 27 , 28 , 29 ], 2 were from 2019 [ 30 , 31 ], and 2020 [ 32 , 33 ], 4 were from 2021 [ 34 , 35 , 36 , 37 ], and 2022 [ 38 , 39 , 40 , 41 ]. Zero studies were from 2018.…”

Preliminary Effectiveness of a Remotely Monitored Blood Alcohol Concentration Device as Treatment Modality: Protocol for a Randomized Controlled Trial

“…The study will utilize a parallel randomized controlled trial design including 2 groups (Aware treatment only versus Soberlink plus Aware treatment), in which the Aware treatment only group will act as an active control group (a further detailed explanation of the groups is described below). The block randomization sequence will allow for equal representation between the 2 groups without bias on gender, age, or ethnicity, given that all individuals will be categorized as a single variable [ 27 ]. The intervention for both groups will last for 3 months with a 6-week follow-up, during which each participant will be interviewed at admission (T1), 1 month in (T2), 2 months in (T3), 3 months in (T4), and follow-up (T5), as seen in Figure 1 [ 28 ].…”