Kwon Manjae, Moon Daa Un, Kang Minjae, Jung Young-Chul
Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
JMIR Form Res. 2025 Mar 19;9:e64459. doi: 10.2196/64459.
Alcohol consumption is a leading cause of death and disability worldwide, associated with numerous acute and chronic medical conditions. Digital health interventions offer a promising solution to overcome barriers associated with traditional treatment methods, providing accessible, scalable, and cost-effective means to support individuals in reducing hazardous drinking.
This pilot study aims to evaluate the feasibility, acceptability, and preliminary efficacy of the Sober smartphone app in individuals with hazardous alcohol use.
This single-group, pre- and postpilot study included 20 participants with risky alcohol use, identified using the Alcohol Use Disorder Identification Test. Participants used the Sober app for 4 weeks, incorporating cognitive behavioral therapy-based interventions. Feasibility was assessed by study and session completion rates, acceptability by participant satisfaction and perceived usefulness, and preliminary efficacy by changes in alcohol consumption and psychiatric symptoms. Semistructured interviews with participants and clinicians provided qualitative perspectives on the app's usability, efficacy, and areas for improvement.
Of the 20 enrolled participants, 17 completed the study. The app demonstrated high feasibility with an 85% (17/20) study completion rate, and 59% (10/17) completed all cognitive behavioral therapy sessions. Participants reported positive acceptability, with average satisfaction and usefulness ratings of 3.8 and 3.7 of 5, respectively. Preliminary efficacy outcomes showed significant improvements: abstinence days increased from 67% to 85% (z=-3.17; P=.002), heavy drinking episodes decreased from 3.3 to 1.9 (t16=-2.97; P=.003), and total alcohol consumption reduced from 456.8 to 195.9 mL (t16=3.16; P=.002). Alcohol Use Disorder Identification Test scores dropped from 17.5 to 10.7 (t16=4.51; P<.001). Additionally, depression (Patient Health Questionnaire-9) scores decreased from 5.8 to 4.4 (t16=2.91; P=.01), and anxiety (Generalized Anxiety Disorder-7) scores from 3.4 to 2.1 (z=-2.80; P=.005). No adverse events were reported. Qualitative analysis found participants valued daily logging but noted usability issues, while clinicians called for tailored goals, enhanced communication features, and age-specific content.
The mobile app Sober shows promise as an effective tool for reducing hazardous alcohol consumption and improving related psychiatric symptoms. The study demonstrated high feasibility and positive acceptability, with significant preliminary efficacy in reducing alcohol use. Qualitative findings provided actionable evidence for refining the app's usability and clinical integration. Further research through a randomized controlled trial is warranted to confirm these findings and optimize the app's features and content.
饮酒是全球范围内导致死亡和残疾的主要原因，与众多急慢性疾病相关。数字健康干预为克服传统治疗方法的相关障碍提供了一个有前景的解决方案，提供了可及、可扩展且具成本效益的方式来支持个体减少有害饮酒。
本试点研究旨在评估清醒智能手机应用程序对有害饮酒个体的可行性、可接受性和初步疗效。
这项单组前后试点研究纳入了20名使用酒精使用障碍识别测试确定为有危险饮酒行为的参与者。参与者使用清醒应用程序4周，其中纳入了基于认知行为疗法的干预措施。通过研究和疗程完成率评估可行性，通过参与者满意度和感知有用性评估可接受性，通过饮酒量和精神症状的变化评估初步疗效。对参与者和临床医生进行的半结构化访谈提供了关于该应用程序可用性、疗效及改进领域的定性观点。
在20名登记参与者中，17名完成了研究。该应用程序显示出高可行性，研究完成率为85%（17/20），59%（10/17）的参与者完成了所有认知行为疗法疗程。参与者报告了积极的可接受性，平均满意度和有用性评分分别为5分制中的3.8分和3.7分。初步疗效结果显示有显著改善：戒酒天数从67%增加到85%（z=-3.17；P=.002），重度饮酒发作次数从3.3次减少到1.9次（t16=-2.97；P=.003），总饮酒量从456.8毫升减少到195.9毫升（t16=3.16；P=.002）。酒精使用障碍识别测试得分从17.5降至10.7（t16=4.51；P<.001）。此外，抑郁（患者健康问卷-9）得分从5.8降至4.4（t16=2.91；P=.01），焦虑（广泛性焦虑障碍-7）得分从3.4降至2.1（z=-2.80；P=.005）。未报告不良事件。定性分析发现参与者重视每日记录，但指出了可用性问题，而临床医生呼吁设定个性化目标、增强沟通功能以及提供针对特定年龄的内容。
移动应用程序清醒显示出有望成为减少有害饮酒和改善相关精神症状的有效工具。该研究证明了高可行性和积极的可接受性，在减少酒精使用方面有显著的初步疗效。定性研究结果为改进该应用程序的可用性和临床整合提供了可采取行动的证据。有必要通过随机对照试验进行进一步研究以证实这些发现并优化该应用程序的功能和内容。
