Using alcohol biosensors and biomarkers to measure changes in drinking: Associations between transdermal alcohol concentration, phosphatidylethanol, and self-report in a contingency management study of persons with and without HIV.

Abstract

Alcohol use can be measured in many ways, including objectively through transdermal alcohol biosensors (e.g., transdermal alcohol concentration; TAC) or blood biomarkers (e.g., phosphatidylethanol; PEth), or subjectively through self-report (e.g., with the timeline followback; TLFB). However, it is unclear which measures best indicate changes in alcohol use within individuals following intervention, and if they have concurrent validity. In the context of contingency management (CM) with a goal of 30-day abstinence (n = 45, 60% male, 80% Black; Mage = 56.7; 58% with HIV), we examined relationships among changes in TAC-AUC (area under the curve, reflecting volume consumed), PEth, and self-reported number of drinks. The Secure Continuous Remote Alcohol Monitor Continuous Alcohol Monitoring (SCRAM-CAM) biosensor was used to collect TAC-AUC during a pre-CM period (∼7 days) and over a 30-day CM period. PEth was collected at baseline and 30-day follow-up. Number of drinks was self-reported through a 30-day TLFB at baseline and follow-up. Daily TAC-AUC and number of self-reported drinks were calculated for the pre-CM period and for the last 7 days of the CM period. Linear regression models controlling for baseline values revealed that change in TAC-AUC was significantly associated with change in PEth (β = 0.33, p < .0001) and with change in number of self-reported drinks (β = 0.34, p < .0001). Change in PEth was significantly associated with change in number of self-reported drinks (β = 0.85, p < .0001). We conclude that all three measures may be appropriate for measuring within-person change in alcohol use, while controlling for baseline values, in the context of a study testing an intervention such as CM.

Resting state connectivity in people living with HIV before and after stopping heavy drinking

“…Data were downloaded from the server through a password-protected portal. The Transdermal Alcohol Sensor Data Macro (TASMAC Software) read and interpreted data from the SCRAM” ( 62 ). The participant took the DirectConnect device home so that the research assistant could check their daily data.…”

Signal processing and machine learning with transdermal alcohol concentration to predict natural environment alcohol consumption.

“…This software is capable of processing whole cohorts of data, advancing the ability for researchers to efficiently identify alcohol consumption in participants' natural environment. Future directions include training models to predict device removal, drinking intensity, or breath alcohol concentration, examining whether demographics or other biomarkers contribute to model accuracy (Richards et al, 2023), and continuing to validate the present models with TAC data from diverse environments and samples.…”

Use of Transdermal Alcohol Sensors in Conjunction With Contingency Management to Reduce Alcohol Consumption in People With Alcohol Dependence Attending Alcohol Treatment Services: Protocol for a Pilot Feasibility Randomized Controlled Trial

“…The implementation of this is not feasible with staff time and resources and multiple daily visits would increase the burden on both patients and staff, as well as being potentially invasive. However, with the development of TAS, there is now the possibility to objectively monitor alcohol consumption 24/7 without these barriers [19,20,[41][42][43][44][45][46].…”

“…Previous literature has started to explore TAS use to implement CM [19,20,[41][42][43][44][45][46]. These studies found TAS successful in implementing the CM procedure and found that the CM intervention was able to significantly reduce alcohol consumption [19,20,42,43].…”

“…Of these studies, none involved alcohol-dependent participants. Two used recent drinking while intoxicated ( DWI) offenders with differing criteria on alcohol consumption, one AUDIT (Alcohol Use Disorder Identification Test) score of 4+ [44] and the other AUDIT score of 8+ [41], two used human immunodeficiency viruses (HIV)-diagnosed individuals drinking higher levels of alcohol consumption [45,46], and the other four classified as risky or heavy drinks with varying ways to define this [19,20,42,43]. The length of the TAS wear periods and CM length ranged from one month to four months.…”