Treatment seeking as a mechanism of change in a randomized controlled trial of a mobile health intervention to support recovery from alcohol use disorders

In Journal of Substance Abuse Treatment, Joseph Glass and colleagues, including James McKay, assessed the efficacy of an Addiction-Comprehensive Health Enhancement Support System (A-CHESS) in increasing the use of services for addiction. This model is an electronic health framework that has been applied to a diverse set of health problems, including pediatric asthma and breast and lung cancer, and was previously adopted to alcohol addiction in a randomized-controlled trial. The authors conducted secondary data analyses of this trial, including 349 adults with alcohol use disorders. Those randomized to the intervention received a smartphone, the A-CHESS mobile application, and an 8-month service plan. Control arm participants received treatment as usual. Telephone interviews at 4, 8, and 12-month follow-ups assessed past-month risky drinking days, past-month abstinence, and post-discharge use of services (including outpatient care and mutual help such as Alcoholics Anonymous). The authors find that assignment to the A-CHESS intervention is associated with an increased odds of outpatient addiction treatment across follow-ups, but not of mutual help (such as with A.A). The effect of A-CHESS through outpatient addiction appeared to reduce the expected number of risky drinking days by 11%, but did not affect abstinence. They conclude that this mobile health intervention promotes the use of outpatient addiction treatment, which appears to reduce risky drinking. Future research should investigate how mobile health interventions could link patients to needed treatment services and promote the sustained use of these services.