Mobile Health App for Alcoholism

Overseen By Alice Pulvermacher

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Wisconsin, Madison

Disqualifiers: Severe alcohol use disorder, Psychotic disorder, Acute medical problem, Terminal illness

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a mobile health app's impact on reducing risky drinking days and improving the quality of life for people with alcohol use disorder. The app, A-CHESS, is tested in three ways: self-monitored, with peer support, and with a health coach. Individuals who have recently consumed a high number of drinks in a week and wish to reduce their drinking might be a good fit. Participants must live within the UW Health system area and have a smartphone. As an unphased trial, this study offers participants the chance to contribute to innovative research that could enhance support for alcohol use disorder.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this mobile health app is safe for patients with alcohol use disorder?

Research has shown that the A-CHESS smartphone app is well-received by people with alcohol use disorder. In one study, the app, which helps users monitor their drinking and offers support, led to positive results. Specifically, users reported fewer days of risky drinking, decreasing from about 38% to 22% over a year.

For the version of the app that includes peer support, studies have found that users are more likely to seek extra outpatient treatment, which improves recovery. For the version integrated with clinical care, users experienced significant improvements in mental health and quality of life.

Overall, these findings suggest that the app is safe and effective in helping people reduce alcohol consumption and enhance their well-being. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments for alcoholism because they leverage technology in unique ways to support recovery. The A-CHESS app offers three approaches: self-monitored, peer-supported, and clinically-integrated. Unlike traditional treatments that might involve medication or in-person therapy, the app provides a digital platform for self-monitoring and goal-setting, giving patients more autonomy. The peer-supported option adds a social aspect, connecting users with others on similar journeys and offering encouragement from a sponsor with successful reduction history. The clinically-integrated approach goes a step further by involving a health coach, who can access patient data to provide personalized guidance and support, which might enhance engagement and outcomes. This integration of digital tools with personal support could transform how we approach treatment for alcoholism.

What evidence suggests that this trial's treatments could be effective for alcohol use disorder?

Studies have shown that the A-CHESS app can help people with alcohol use disorder drink less and maintain sobriety more often. In this trial, participants will join one of three groups: the self-monitored group, the peer-supported group, or the clinically integrated group. Research indicates that the app's peer support feature, available in the peer-supported group, enhances coping skills and helps users adhere to their recovery goals. A-CHESS includes tools like a drink tracker and tips for reducing alcohol consumption, which have been linked to fewer relapses. The clinically integrated version, featuring a health coach, provides additional support by guiding users through their recovery journey. Both the peer-supported and clinically integrated versions have shown promise in helping people stay on track with their recovery and improve their overall quality of life. ^{1 5 6 7 8}

Who Is on the Research Team?

Andrew Quanbeck, PhD

Principal Investigator

University of Wisconsin, Madison

Are You a Good Fit for This Trial?

This trial is for adults over 21 within the UW Health system area who want to cut down on drinking, meet criteria for risky alcohol use, own a smartphone, and are willing to use the A-CHESS app. It's not for those with severe alcohol disorders, current psychosis, immediate hospitalization needs or terminal illness.

Inclusion Criteria

meets the criteria for at risk drinking on the AUDIT screening

be able to understand and sign an electronic consent form in English

You have an Apple or Android smartphone.

Exclusion Criteria

You currently have a mental illness that causes you to lose touch with reality.

have an acute medical problem requiring immediate hospitalization

You have a severe problem with drinking too much alcohol (more than 6 items on a diagnostic test called the AUD).

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

72 hours

Run-in

Participants undergo a 72-hour run-in period before randomization

72 hours

Intervention

Participants receive access to the mHealth system with different implementation strategies based on group assignment

12 weeks

Weekly virtual check-ins via app

Follow-up

Participants are monitored for safety and effectiveness after the intervention period

9 months

What Are the Treatments Tested in This Trial?

Interventions

• A-CHESS clinically-integrated
• A-CHESS peer-supported
• A-CHESS self-monitored

Trial Overview The study tests three ways of using the A-CHESS mobile app in helping people with alcohol use disorder: self-monitored use; peer-supported monitoring; and clinical integration with a health coach. Participants will be divided into these groups randomly.

How Is the Trial Designed?

Group I: Peer supported Experimental Treatment 1 Intervention

Patients will be asked to take the same surveys and have the access to the same information as the self-monitoring group. Patient subjects in this group will have access to discussion boards where they can talk to one another and have the ability to share and see stories of other patients. The only involvement of someone other than patients themselves in the peer-supported group will be by a sponsor (i.e., a dedicated user from the area with a sustained history of successful alcohol reduction). The sponsor will participate in discussion groups and encourage use of the system. Patient-reported feedback will be presented directly to the patient.

Group II: Clinically integrated Experimental Treatment 1 Intervention

Patients in the clinically integrated group will receive the same intervention as the peer-supported group aside from three differences: 1) patients have the option to share selected elements of their app data with the University of Wisconsin (UW) Health health coach, 2) the health coach will replace the role of the sponsor in the peer-support group, and 3) patients will have the option to attend an initial 60- to 90-minute and two 30-minute follow-up consultations with the health coach in-person, via phone, or via video chat.

Group III: Self monitored Active Control 1 Intervention

Patients of this group will continue receiving regular care from their physician with no interference from the two experimental groups. Patient subjects will download the app on their Android or Apple smart phone that will direct them to external information hosted on the internet that may help reduce their drinking (e.g., NIAAA resources). For the first 12 weeks, once a week patients can set a weekly goal related to their alcohol use or other health related behaviors (e.g., "I will only drink on Friday this week."). At the end of the week subjects will be prompted to take a weekly survey, which will include questions such as a variation of the brief alcohol monitor (BAM) and timeline followback. Patients will then receive feedback on the amount of drinks they had compared to their goal. Then the patient will set a new goal for the following week. Patients will complete quarterly surveys on the A-CHESS app to assess study outcomes.

Who Is Running the Clinical Trial?

University of Wisconsin, Madison

Lead Sponsor

Trials

1,249

Recruited

3,255,000+

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Collaborator

Trials

865

Recruited

1,091,000+

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT04011644?tab=results

Mobile Health for Alcohol Use Disorders in Clinical ... A-CHESS clinically-integrated: Patients have access to a smart phone app that provides information on tips on how to reduce drinking, a drink tracker, a journal ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4016167/

A smartphone application to support recovery from ... It was hypothesized that patients with A-CHESS would have fewer risky drinking days (the primary outcome) as well as greater abstinence and fewer negative ...

3. c4tbh.org c4tbh.org/program-review/addiction-comprehensive-health-enhancement-support-system-a-chess/

Addiction-Comprehensive Health Enhancement Support ... A-CHESS is a smartphone application designed to provide continuing care to patients with alcohol use disorders.

4. chess.health chess.health/evidence/research/

Research This study by the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) shows positive outcomes for outpatients with substance use ...

5. jamanetwork.com jamanetwork.com/journals/jamapsychiatry/fullarticle/1847578

A Smartphone Application to Support Recovery From ... The findings suggest that a multifeatured smartphone application may have significant benefit to patients in continuing care for alcohol use disorders.

6. chess.health chess.health/evidence/

Evidence This study by the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) shows positive outcomes for outpatients with substance use ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11399417/

A randomized trial testing digital medicine support models ... The clinically integrated group showed significant improvements in mental health and quality of life compared to the self-monitoring group (p = 0.011). However, ...

8. chess.health chess.health/research/tech-based-interventions-offer-promise-for-alcohol-use-disorder/

Tech-Based Interventions Offer Promise for Alcohol Use ... A review of studies reveals that technology-based solutions positively impact recovery for individuals with alcohol and drug abuse ...