What hepatology clinicians and their patients with alcohol-related liver disease think of wearable alcohol biosensors to aid abstinence from alcohol: A qualitative study.

INTRODUCTION

We aimed to determine acceptability and feasibility of innovative wearable alcohol biosensor monitors (ABM) for patients with alcohol-related liver disease (ALD) and their clinicians.

METHODS

Patients and clinicians at a tertiary care centre participated in qualitative interviews on usability, acceptability, feasibility, efficiency/effectiveness, impact of device on behaviour/clinical practice and preferences/barriers. Interviews were audiotaped, transcribed and coded using a constant comparison method for category themes.

RESULTS

Patients (n = 23) were 56% female, mean 44 years old, 87% White, with moderate-severe liver disease. Some felt the ABMs appearance was unappealing; others felt it provided an opportunity for openness and education of others. While some found it feasible to wear, others felt it was unrealistic to wear 24/7. Importantly, there were many positive themes on effectiveness/efficiency-participants felt the ABM could better record their alcohol use and patterns of use than they could remember. Patients felt wearing the ABM motivated abstinence, gave accountability and was a source of security. Clinicians (n = 13) were mostly hepatologists (77%), seeing on average 38 ALD patients/month. Clinicians felt seeing patterns and amounts of alcohol use could inform clinical decision making and treatments but expressed concern over the volume and complexity of data.

DISCUSSION AND CONCLUSIONS

Perspectives on ABMs for managing ALD were mixed among patients and providers. Future device designs may overcome acceptability barriers due to device appearance. However, for clinicians, the logistics of data gathering plus the complexity and volume of data produced by the ABM device requires considerable thought to make this an efficient tool for clinical use.

CLINICALTRIALS

gov identifier NCT03533660: Alcohol biosensor monitoring for alcohol liver disease.