TY - JOUR
KW - Adolescent
KW - Adult
KW - Aged
KW - Alcohol Abstinence/psychology
KW - Alcohol Drinking/prevention & control/psychology
KW - Alcoholism/diagnosis/psychology/therapy
KW - Automation
KW - Continuity of Patient Care
KW - Counseling/methods
KW - Female
KW - Health Services Accessibility
KW - Humans
KW - Interpersonal Relations
KW - Male
KW - Middle Aged
KW - Philadelphia
KW - Prospective Studies
KW - Randomized Controlled Trials as Topic
KW - Recurrence
KW - smartphone
KW - Telemedicine/methods
KW - Telephone
KW - Time Factors
KW - Treatment Outcome
KW - Young Adult
KW - A-CHESS
KW - Alcohol use disorder
KW - Alcohol use outcomes
KW - Automated recovery support
KW - Continuing care
KW - cost-effectiveness
KW - Drug use outcomes
KW - Intervention costs
KW - Mobile Health
KW - Telephone counseling
AU - J. R. McKay
AU - D. H. Gustafson
AU - M. Ivey
AU - F. McTavish
AU - K. Pe-Romashko
AU - B. Curtis
AU - D. A. Oslin
AU - D. Polsky
AU - A. Quanbeck
AU - K. G. Lynch
A1 - 
AB - BACKGROUND: New smartphone communication technology provides a novel way to provide personalized continuing care support following alcohol treatment. One such system is the Addiction version of the Comprehensive Health Enhancement Support System (A-CHESS), which provides a range of automated functions that support patients. A-CHESS improved drinking outcomes over standard continuing care when provided to patients leaving inpatient treatment. Effective continuing care can also be delivered via telephone calls with a counselor. Telephone Monitoring and Counseling (TMC) has demonstrated efficacy in two randomized trials with alcohol-dependent patients. A-CHESS and TMC have complementary strengths. A-CHESS provides automated 24/7 recovery support services and frequent assessment of symptoms and status, but does not involve regular contact with a counselor. TMC provides regular and sustained contact with the same counselor, but no ongoing support between calls. The future of continuing care for alcohol use disorders is likely to involve automated mobile technology and counselor contact, but little is known about how best to integrate these services. METHODS/DESIGN: To address this question, the study will feature a 2 x 2 design (A-CHESS for 12 months [yes/no] x TMC for 12 months [yes/no]), in which 280 alcohol-dependent patients in intensive outpatient programs (IOPs) will be randomized to one of the four conditions and followed for 18 months. We will determine whether adding TMC to A-CHESS produces fewer heavy drinking days than TMC or A-CHESS alone and test for TMC and A-CHESS main effects. We will determine the costs of each of the four conditions and the incremental cost-effectiveness of the three active conditions. Analyses will also examine secondary outcomes, including a biological measure of alcohol use, and hypothesized moderation and mediation effects. DISCUSSION: The results of the study will yield important information on improving patient alcohol use outcomes by integrating mobile automated recovery support and counselor contact. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02681406 . Registered on 2 September 2016.
AD - Center on Continuum of Care in Addictions, Perelman School of Medicine, University of Pennsylvania, Philadelphia VAMC, Philadelphia, PA, 19104, USA. jimrache@pennmedicine.upenn.edu.; Center for Health Enhancement System Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA.; Center on Continuum of Care in Addictions, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.; Center for Health Enhancement System Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA.; Center for Health Enhancement System Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA.; Center on Continuum of Care in Addictions, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.; Center for the Study of Addictions, Perelman School of Medicine, University of Pennsylvania, Philadelphia VAMC, Philadelphia, PA, 19104, USA.; Leonard Davis Institute of Health Economics and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.; Department of Family Medicine & Community Health, and Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, 53706, USA.; Center on Continuum of Care in Addictions, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
BT - Trials
C5 - Financing & Sustainability; HIT & Telehealth; Opioids & Substance Use
CP - 1
CY - England
DO - 10.1186/s13063-018-2466-1
IS - 1
JF - Trials
M1 - Journal Article
N2 - BACKGROUND: New smartphone communication technology provides a novel way to provide personalized continuing care support following alcohol treatment. One such system is the Addiction version of the Comprehensive Health Enhancement Support System (A-CHESS), which provides a range of automated functions that support patients. A-CHESS improved drinking outcomes over standard continuing care when provided to patients leaving inpatient treatment. Effective continuing care can also be delivered via telephone calls with a counselor. Telephone Monitoring and Counseling (TMC) has demonstrated efficacy in two randomized trials with alcohol-dependent patients. A-CHESS and TMC have complementary strengths. A-CHESS provides automated 24/7 recovery support services and frequent assessment of symptoms and status, but does not involve regular contact with a counselor. TMC provides regular and sustained contact with the same counselor, but no ongoing support between calls. The future of continuing care for alcohol use disorders is likely to involve automated mobile technology and counselor contact, but little is known about how best to integrate these services. METHODS/DESIGN: To address this question, the study will feature a 2 x 2 design (A-CHESS for 12 months [yes/no] x TMC for 12 months [yes/no]), in which 280 alcohol-dependent patients in intensive outpatient programs (IOPs) will be randomized to one of the four conditions and followed for 18 months. We will determine whether adding TMC to A-CHESS produces fewer heavy drinking days than TMC or A-CHESS alone and test for TMC and A-CHESS main effects. We will determine the costs of each of the four conditions and the incremental cost-effectiveness of the three active conditions. Analyses will also examine secondary outcomes, including a biological measure of alcohol use, and hypothesized moderation and mediation effects. DISCUSSION: The results of the study will yield important information on improving patient alcohol use outcomes by integrating mobile automated recovery support and counselor contact. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02681406 . Registered on 2 September 2016.
PP - England
PY - 2018
SN - 1745-6215; 1745-6215
SP - 018
EP - 1
EP - 82+
T1 - Effects of automated smartphone mobile recovery support and telephone continuing care in the treatment of alcohol use disorder: study protocol for a randomized controlled trial
T2 - Trials
TI - Effects of automated smartphone mobile recovery support and telephone continuing care in the treatment of alcohol use disorder: study protocol for a randomized controlled trial
U1 - Financing & Sustainability; HIT & Telehealth; Opioids & Substance Use
U2 - 29382367
U3 - 10.1186/s13063-018-2466-1
VL - 19
VO - 1745-6215; 1745-6215
Y1 - 2018
Y2 - Jan 30
ER -