%0 Journal Article
%T A smartphone application to support recovery from alcoholism: a randomized clinical trial
%J JAMA Psychiatry
%D 2014
%A Gustafson, David H.
%A McTavish, Fiona M.
%A Chih, Ming-Yuan
%A Atwood, Amy K.
%A Johnson, Roberta A.
%A Boyle, Michael G.
%A Levy, Michael S.
%A Driscoll, Hilary
%A Chisholm, Steven M.
%A Dillenburg, Lisa
%A Isham, Andrew
%A Shah, Dhavan
%V 71
%N 5
%P 566-572
%X IMPORTANCE Patients leaving residential treatment for alcohol use disorders are not typically offered evidence-based continuing care, although research suggests that continuing care is associated with better outcomes. A smartphone-based application could provide effective continuing care. <br><br>OBJECTIVE To determine whether patients leaving residential treatment for alcohol use disorders with a smartphone application to support recovery have fewer risky drinking days than control patients. DESIGN, SETTING, AND PARTICIPANTS An unmasked randomized clinical trial involving 3 residential programs operated by 1 nonprofit treatment organization in the Midwestern United States and 2 residential programs operated by 1 nonprofit organization in the Northeastern United States. In total, 349 patients who met the criteria for DSM-IV alcohol dependence when they entered residential treatment were randomized to treatment as usual (n = 179) or treatment as usual plus a smartphone (n = 170) with the Addiction-Comprehensive Health Enhancement Support System (A-CHESS), an application designed to improve continuing care for alcohol use disorders. INTERVENTIONS Treatment as usual varied across programs; none offered patients coordinated continuing care after discharge. A-CHESS provides monitoring, information, communication, and support services to patients, including ways for patients and counselors to stay in contact. The intervention and follow-up period lasted 8 and 4 months, respectively. MAIN OUTCOMES AND MEASURES Risky drinking days-the number of days during which a patient's drinking in a 2-hour period exceeded 4 standard drinks for men and 3 standard drinks for women, with standard drink defined as one that contains roughly 14 g of pure alcohol (12 oz of regular beer, 5 oz of wine, or 1.5 oz of distilled spirits). Patients were asked to report their risky drinking days in the previous 30 days on surveys taken 4, 8, and 12 months after discharge from residential treatment. <br><br>RESULTS For the 8 months of the intervention and 4 months of follow-up, patients in the A-CHESS group reported significantly fewer risky drinking days than did patients in the control group, with a mean of 1.39 vs 2.75 days (mean difference, 1.37; 95% CI, 0.46-2.27; P = .003). <br><br>CONCLUSIONS AND RELEVANCE The findings suggest that a multifeatured smartphone application may have significant benefit to patients in continuing care for alcohol use disorders. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01003119.<p /> <p>Language: en</p>
%G en
%I American Medical Association
%@ 2168-622X
%U http://dx.doi.org/10.1001/jamapsychiatry.2013.4642