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一种用于酒精使用障碍治疗的新型远程医疗平台:饮酒量减少的初步证据。

A novel telehealth platform for alcohol use disorder treatment: preliminary evidence of reductions in drinking.

作者信息

Mitchell Mary M, Mendelson John, Gryczynski Jan, Carswell Steven B, Schwartz Robert P

机构信息

Friends Research Institute , Baltimore, MD, USA.

Ria Health , San Francisco, CA, USA.

出版信息

Am J Drug Alcohol Abuse. 2020 May 3;46(3):297-303. doi: 10.1080/00952990.2019.1658197. Epub 2019 Oct 9.

Abstract

BACKGROUND

Alcohol use disorder (AUD) treatment remains greatly underutilized. Innovative strategies are needed to improve AUD treatment access and patient engagement. The Ria Treatment Platform (RTP) is a patient-centered telemedicine AUD treatment program accessed through a smartphone application (app) that includes a package of physician visits (with AUD prescriptions as appropriate), text- and phone-based support from a recovery coach, video monitoring of medication adherence, and Bluetooth-linked breathalyzer tracking of alcohol intake.

OBJECTIVES

The purpose of the current study is to examine changes in alcohol use among patients utilizing the RTP.

METHODS

This study examines daily breathalyzer blood alcohol content (BAC) readings collected from 77 adult patients (50.7% male) over the first 90 days in treatment with the RTP. Data were analyzed using dynamic structural equation modeling.

RESULTS

The treatment retention rate at 90 days was 55%. The best fit for the BAC data was given by a cubic curve, which showed that among patients who remained engaged for 90 days average BAC levels declined approximately 50% (from .091 to .045) from baseline to day 90.

CONCLUSION

This study provides preliminary evidence of substantial alcohol use reductions among patients utilizing the RTP, an innovative telemedicine program accessed via smartphone. Although other alcohol-reduction apps have shown promise from scientific evaluations, the RTP appears to be the only app that incorporates physician-prescribed medication and a recovery coach. Research incorporating random assignment and meaningful comparison groups is needed to further evaluate this promising strategy.

摘要

背景

酒精使用障碍(AUD)治疗的利用率仍然极低。需要创新策略来改善AUD治疗的可及性和患者参与度。里亚治疗平台(RTP)是一个以患者为中心的远程医疗AUD治疗项目,通过智能手机应用程序(应用)访问,该应用包括一系列医师问诊(酌情开具AUD处方)、康复教练提供的基于文本和电话的支持、药物依从性的视频监测以及通过蓝牙连接的酒精检测仪跟踪酒精摄入量。

目的

本研究的目的是检查使用RTP的患者的酒精使用情况变化。

方法

本研究检查了在使用RTP治疗的前90天从77名成年患者(50.7%为男性)收集的每日酒精检测仪血液酒精含量(BAC)读数。使用动态结构方程模型分析数据。

结果

90天时的治疗保留率为55%。BAC数据的最佳拟合曲线为三次曲线,该曲线显示,在持续参与治疗90天的患者中,平均BAC水平从基线到第90天下降了约50%(从0.091降至0.045)。

结论

本研究提供了初步证据,表明使用RTP(一种通过智能手机访问的创新远程医疗项目)的患者的酒精使用量大幅减少。尽管其他减少酒精使用的应用程序在科学评估中显示出了前景,但RTP似乎是唯一一款结合了医生开的药物和康复教练的应用程序。需要纳入随机分配和有意义的对照组的研究来进一步评估这一有前景的策略。

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