Background and Aims: Alcohol use disorder (AUD) is a substantial problem, causing early death and great economic burden. Research has highlighted the potential positive impact of technological interventions, such as smartphone applications (app) in treatment of AUD. The aim of this study was to explore the effectiveness of a smartphone app, incorporating computerized cognitive behavioural therapy and text messaging support, on alcohol outcomes over 6 months in a post-rehabilitation setting. Methods: A total of 111 participants with AUD were recruited into this randomized controlled trial, following completion of a 30-day rehabilitation programme. The intervention group (n = 54) used the smartphone app “UControlDrink” (UCD) over 6 months with treatment as usual (TAU), and the control group (n = 57) received TAU. All subjects suffered from AUD as the primary disorder, with other major psychiatric disorders excluded. All intervention subjects used the UCD smartphone app in the treatment trial, and all subjects underwent TAU consisting of outpatient weekly support groups. Drinking history in the previous 90 days was measured at baseline and at 3- and 6-month follow-ups. Additional measurements were made to assess mood, anxiety, craving, and motivation. Results were analysed using intention-to-treat analyses. Results: Retention in the study was 72% at 3 months and 52% at 6 months. There was a significant reduction in heavy drinking days in the intervention group relative to TAU over the 6 months, p < 0.02. Conclusions: The UCD smartphone app demonstrates a significant benefit to reducing heavy drinking days over a 6-month post-rehabilitation period in AUD.

1.
Rehm
J
,
Baliunas
D
,
Borges
GL
,
Graham
K
,
Irving
H
,
Kehoe
T
,
The relation between different dimensions of alcohol consumption and burden of disease: an overview
.
Addiction
.
2010
;
105
(
5
):
817
43
. .
2.
Rehm
J
,
Shield
KD
,
Gmel
G
,
Rehm
MX
,
Frick
U
.
Modeling the impact of alcohol dependence on mortality burden and the effect of available treatment interventions in the European Union
.
Eur Neuropsychopharmacol
.
2013
;
23
(
2
):
89
97
. .
3.
Bradizza
CM
,
Stasiewicz
PR
,
Paas
ND
.
Relapse to alcohol and drug use among individuals diagnosed with co-occurring mental health and substance use disorders: a review
.
Clin Psychol Rev
.
2006
;
26
(
2
):
162
78
. .
4.
Cohen
E
,
Feinn
R
,
Arias
A
,
Kranzler
HR
.
Alcohol treatment utilization: findings from the national epidemiologic survey on alcohol and related conditions
.
Drug Alcohol Depend
.
2007
;
86
(
2–3
):
214
21
. .
5.
Moos
RH
,
Moos
BS
.
Rates and predictors of relapse after natural and treated remission from alcohol use disorders
.
Addiction
.
2006
;
101
(
2
):
212
22
. .
6.
Farren
CK
,
Murphy
P
,
McElroy
S
.
A 5-year follow-up of depressed and bipolar patients with alcohol use disorder in an Irish population
.
Alcohol Clin Exp Res
.
2014
;
38
(
4
):
1049
58
. .
7.
Gual
A
,
He
Y
,
Torup
L
,
van den Brink
W
,
Mann
K
,
Group
ES
.
A randomised, double-blind, placebo-controlled, efficacy study of nalmefene, as-needed use, in patients with alcohol dependence
.
Eur Neuropsychopharmacol
.
2013
;
23
(
11
):
143242
. .
8.
Mann
K
,
Bladström
A
,
Torup
L
,
Gual
A
,
van den Brink
W
.
Extending the treatment options in alcohol dependence: a randomised controlled study of as-needed nalmefene
.
BioL Psychiatry
.
2013
;
73
(
8
):
706
13
.
9.
ITU
.
International telecommunication union facts and figures
.
Geneva
:
ITU Publication
;
2019
.
10.
Riper
H
,
Kramer
J
,
Smit
F
,
Conijn
B
,
Schippers
G
,
Cuijpers
P
.
Web-based self-help for problem drinkers: a pragmatic randomised trial
.
Addiction
.
2008
;
103
(
2
):
218
27
.
11.
Gustafson
DH
,
McTavish
FM
,
Chih
M-Y
,
Atwood
AK
,
Johnson
RA
,
Boyle
MG
,
A smartphone application to support recovery from alcoholism: a randomised clinical trial
.
JAMA Psychiatry
.
2014
;
71
(
5
):
566
72
.
12.
Group Project Match
.
Matching alcoholism treatments to client heterogeneity: project MATCH three-year drinking outcomes
.
Alcohol Clin Exp Res
.
1998
;
22
(
6
):
1300
11
.
13.
Kiluk
BD
,
Devore
KA
,
Buck
MB
,
Nich
C
,
Frankforter
TL
,
LaPaglia
DM
,
Randomised trial of computerised cognitive behavioral therapy for alcohol use disorders: Efficacy as a virtual stand-alone and treatment add-on compared with standard outpatient treatment
.
Alcohol Clin Exp Res
.
2016
;
40
(
9
):
1991
2000
.
14.
Farren
CK
,
Milnes
J
,
Lambe
K
,
Ahern
S
.
Computerised cognitive behavioural therapy for alcohol use disorder: a pilot randomised control trial
.
Ir J Psychol Med
.
2015
;
32
(
3
):
237
46
. .
15.
WHO
.
Global status report on alcohol and health 2018
.
Geneva
:
WHO
;
2019
.
16.
Dulin
PL
,
Gonzalez
VM
,
Campbell
K
.
Results of a pilot test of a self-administered smartphone-based treatment system for alcohol use disorders: usability and early outcomes
.
Subst Abus
.
2014
;
35
(
2
):
168
75
. .
17.
Gajecki
M
,
Berman
AH
,
Sinadinovic
K
,
Rosendahl
I
,
Andersson
C
.
Mobile phone brief intervention applications for risky alcohol use among university students: a randomised controlled study
.
Addict Sci Clin Pract
.
2014
;
9
(
1
):
11
.
18.
Berman
AH
,
Andersson
C
,
Gajecki
M
,
Rosendahl
I
,
Sinadinovic
K
,
Blankers
M
.
Smartphone apps targeting hazardous drinking patterns among university students show differential subgroup effects over 20 weeks: results from a randomised, controlled trial
.
J Clin Med
.
2019
;
8
(
11
):
1807
.
19.
Garnett
C
,
Michie
S
,
West
R
,
Brown
J
.
Updating the evidence on the effectiveness of the alcohol reduction app, drink less: using Bayes factors to analyse trial datasets supplemented with extended recruitment
.
F1000Res
.
2019
;
8
:
114
. .
20.
Sobell
LC
,
Sobell
MB
.
Timeline follow-back
. In:
Measuring alcohol consumption
.
Totowa, NJ
:
Humana Press
;
1992
. p.
41
72
. .
21.
Sobell
LC
,
Sobell
MB
.
Alcohol consumption measures
. In:
Assessing alcohol problems: a guide for clinicians and researchers
. 2nd ed.
Washington, DC
:
US Department of Health and Human Services
;
1995
.
Vol. 2
; p.
75
99
.
22.
Farren
CK
,
Mc Elroy
S
.
Treatment response of bipolar and unipolar alcoholics to an inpatient dual diagnosis program
.
J Affect Disord
.
2008
;
106
(
3
):
265
72
. .
23.
First
M
.
The encyclopedia of clinical psychology
.
New York, NY
:
John Wiley & Sons, Inc
;
2014
.
24.
Folstein
MF
,
Folstein
SE
,
McHugh
PR
.
“Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician
.
J Psychiatr Res
.
1975
;
12
(
3
):
189
98
.
25.
Saunders
JB
,
Aasland
OG
,
Babor
TF
,
De la Fuente
JR
,
Grant
M
.
Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption‐II
.
Addiction
.
1993
;
88
(
6
):
791
804
.
26.
Anton
RF
,
Moak
DH
,
Latham
P
.
The obsessive compulsive drinking scale: a self-rated instrument for the quantification of thoughts about alcohol and drinking behavior
.
Alcohol Clin Exp Res
.
1995
;
19
(
1
):
92
9
.
27.
DiClemente
CC
,
Carbonari
JP
,
Montgomery
RP
,
Hughes
SO
.
The alcohol abstinence self-efficacy scale
.
J Stud Alcohol
.
1994
;
55
(
2
):
141
8
. .
28.
Agyapong
VIO
,
Ahern
S
,
McLoughlin
DM
,
Farren
CK
.
Supportive text messaging for depression and comorbid alcohol use disorder: single-blind randomised trial
.
J Affect Disord
.
2012
;
141
(
2–3
):
168
176
.
29.
Beck
AT
,
Ward
CH
,
Mendelson
M
,
Mock
J
,
Erbaugh
J
.
An inventory for measuring depression
.
Arch Gen Psychiatry
.
1961
;
4
(
6
):
561
71
. .
30.
Beck
AT
,
Epstein
N
,
Brown
G
,
Steer
RA
.
An inventory for measuring clinical anxiety: psychometric properties
.
J Consult Clin Psychol
.
1988
;
56
(
6
):
893
. .
31.
O’Reilly
H
,
Hagerty
A
,
O’Donnell
S
,
Farrell
A
,
Hartnett
D
,
Murphy
E
,
Alcohol use disorder and comorbid depression: a randomised controlled trial investigating the effectiveness of supportive text messages in aiding recovery
.
Alcohol Alcohol
.
2019 Jan 9
;
54
(
5
):
551
8
.
32.
Riper
H
,
Hoogendoorn
A
,
Cuijpers
P
,
Karyotaki
E
,
Boumparis
N
,
Mira
A
,
Effectiveness and treatment moderators of internet interventions for adult problem drinking: an individual patient data meta-analysis of 19 randomised controlled trials
.
PLoS Med
.
2018
;
15
(
12
):
e1002714
. .
33.
Sundström
C
,
Eék
N
,
Kraepelien
M
,
Fahlke
C
,
Gajecki
M
,
Jakobson
M
,
High-versus low-intensity internet interventions for alcohol use disorders: results of a three-armed randomised controlled superiority trial
.
Addiction
.
2020
;
115
(
5
):
863
74
.
34.
Kiluk
BD
,
Ray
LA
,
Walthers
J
,
Bernstein
M
,
Tonigan
JS
,
Magill
M
.
Technology-delivered cognitive-behavioral interventions for alcohol use: a meta-analysis
.
Alcohol Clin Exp Res
.
2019
;
43
(
11
):
2285
95
.
35.
You
CW
,
Chen
YC
,
Chen
CH
,
Lee
CH
,
Kuo
PH
,
Huang
MC
,
Smartphone-based support system (SoberDiary) coupled with a Bluetooth breathalyser for treatment-seeking alcohol-dependent patients
.
Addict Behav
.
2017
;
65
:
174
8
. .
36.
Meredith
SE
,
Alessi
SM
,
Petry
NM
.
Smartphone applications to reduce alcohol consumption and help patients with alcohol use disorder: a state-of-the-art review
.
Adv Health Care Technol
.
2015
;
1
:
47
. .
37.
van den Brink
W
,
Aubin
H-J
,
Bladström
A
,
Torup
L
,
Gual
A
,
Mann
K
.
Efficacy of as-needed nalmefene in alcohol-dependent patients with at least a high drinking risk level: results from a subgroup analysis of two randomised controlled 6-month studies
.
Alcohol Alcohol
.
2013
;
48
(
5
):
570
8
.
38.
Bottlender
M
,
Soyka
M
.
Impact of craving on alcohol relapse during, and 12 months following, outpatient treatment
.
Alcohol Alcohol
.
2004
;
39
(
4
):
357
61
. .
39.
Pettinati
HM
,
Oslin
DW
,
Kampman
KM
,
Dundon
WD
,
Xie
H
,
Gallis
TL
,
A double-blind, placebo-controlled trial combining sertraline and naltrexone for treating co-occurring depression and alcohol dependence
.
Am J Psychiatry
.
2010
;
167
(
6
):
668
75
. .
40.
Farren
CK
,
McElroy
S
.
Predictive factors for relapse after an integrated inpatient treatment programme for unipolar depressed and bipolar alcoholics
.
Alcohol Alcohol
.
2010
;
45
(
6
):
527
33
. .
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.