A Mobile Phone App Featuring Cue Exposure Therapy As Aftercare for Alcohol Use Disorders

An Investigator-Blinded Randomized Controlled Trial

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Resumé

BACKGROUND: Cue exposure therapy (CET) is a psychological approach developed to prepare individuals with alcohol use disorder (AUD) for confronting alcohol and associated stimuli in real life. CET has shown promise when treating AUD in group sessions, but it is unknown whether progressing from group sessions to using a mobile phone app is an effective delivery pathway.

OBJECTIVE: The objectives of this study were to investigate (1) whether CET as aftercare would increase the effectiveness of primary treatment with cognitive behavior therapy, and (2) whether CET delivered through a mobile phone app would be similarly effective to CET via group sessions.

METHODS: A total of 164 individuals with AUD were randomized to one of three groups: CET as group aftercare (CET group), CET as fully automated mobile phone app aftercare (CET app), or aftercare as usual. Study outcomes were assessed face-to-face at preaftercare, postaftercare, and again at 6 months after aftercare treatment. Generalized mixed models were used to compare the trajectories of the groups over time on drinking, cravings, and use of urge-specific coping skills (USCS).

RESULTS: In all, 153 of 164 individuals (93%) completed assessments both at posttreatment and 6-month follow-up assessments. No differences in the trajectories of predicted means were found between the experimental groups (CET group and app) compared with aftercare as usual on drinking and craving outcomes over time. Both CET group (predicted mean difference 5.99, SE 2.59, z=2.31, P=.02) and the CET app (predicted mean difference 4.90, SE 2.26, z=2.31, P=.02) showed increased use of USCS compared to aftercare as usual at posttreatment, but this effect was reduced at the 6-month follow-up. No differences were detected between the two experimental CET groups on any outcomes.

CONCLUSIONS: CET with USCS delivered as aftercare either via group sessions or a mobile phone app did not increase the effectiveness of primary treatment. This suggests that CET with USCS may not be an effective psychological approach for the aftercare of individuals treated for AUD.

TRIAL REGISTRATION: ClinicalTrials.gov NCT02298751; https://clinicaltrials.gov/ct2/show/NCT02298751.

OriginalsprogEngelsk
Artikelnummere13793
TidsskriftJ M I R mHealth and uHealth
Vol/bind7
Udgave nummer8
Antal sider16
ISSN2291-5222
DOI
StatusUdgivet - 16. aug. 2019

Fingeraftryk

Mobile Applications
Implosive Therapy
Cues
Randomized Controlled Trials
Alcohols
Research Personnel
Drinking

Citer dette

@article{b81c80651ac84a86a6a148416ca2f3bb,
title = "A Mobile Phone App Featuring Cue Exposure Therapy As Aftercare for Alcohol Use Disorders: An Investigator-Blinded Randomized Controlled Trial",
abstract = "BACKGROUND: Cue exposure therapy (CET) is a psychological approach developed to prepare individuals with alcohol use disorder (AUD) for confronting alcohol and associated stimuli in real life. CET has shown promise when treating AUD in group sessions, but it is unknown whether progressing from group sessions to using a mobile phone app is an effective delivery pathway.OBJECTIVE: The objectives of this study were to investigate (1) whether CET as aftercare would increase the effectiveness of primary treatment with cognitive behavior therapy, and (2) whether CET delivered through a mobile phone app would be similarly effective to CET via group sessions.METHODS: A total of 164 individuals with AUD were randomized to one of three groups: CET as group aftercare (CET group), CET as fully automated mobile phone app aftercare (CET app), or aftercare as usual. Study outcomes were assessed face-to-face at preaftercare, postaftercare, and again at 6 months after aftercare treatment. Generalized mixed models were used to compare the trajectories of the groups over time on drinking, cravings, and use of urge-specific coping skills (USCS).RESULTS: In all, 153 of 164 individuals (93{\%}) completed assessments both at posttreatment and 6-month follow-up assessments. No differences in the trajectories of predicted means were found between the experimental groups (CET group and app) compared with aftercare as usual on drinking and craving outcomes over time. Both CET group (predicted mean difference 5.99, SE 2.59, z=2.31, P=.02) and the CET app (predicted mean difference 4.90, SE 2.26, z=2.31, P=.02) showed increased use of USCS compared to aftercare as usual at posttreatment, but this effect was reduced at the 6-month follow-up. No differences were detected between the two experimental CET groups on any outcomes.CONCLUSIONS: CET with USCS delivered as aftercare either via group sessions or a mobile phone app did not increase the effectiveness of primary treatment. This suggests that CET with USCS may not be an effective psychological approach for the aftercare of individuals treated for AUD.TRIAL REGISTRATION: ClinicalTrials.gov NCT02298751; https://clinicaltrials.gov/ct2/show/NCT02298751.",
keywords = "aftercare, alcohol use disorder, cognitive behavior therapy, cue exposure therapy, mobile phone app, randomized controlled trial",
author = "Mellentin, {Angelina Isabella} and Bent Nielsen and Nielsen, {Anette S{\o}gaard} and Fei Yu and Anna Mejldal and Nielsen, {Dorthe Gr{\"u}ner} and Elsebeth Stenager",
year = "2019",
month = "8",
day = "16",
doi = "10.2196/13793",
language = "English",
volume = "7",
journal = "J M I R mHealth and uHealth",
issn = "2291-5222",
publisher = "J M I R Publications, Inc.",
number = "8",

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TY - JOUR

T1 - A Mobile Phone App Featuring Cue Exposure Therapy As Aftercare for Alcohol Use Disorders

T2 - An Investigator-Blinded Randomized Controlled Trial

AU - Mellentin, Angelina Isabella

AU - Nielsen, Bent

AU - Nielsen, Anette Søgaard

AU - Yu, Fei

AU - Mejldal, Anna

AU - Nielsen, Dorthe Grüner

AU - Stenager, Elsebeth

PY - 2019/8/16

Y1 - 2019/8/16

N2 - BACKGROUND: Cue exposure therapy (CET) is a psychological approach developed to prepare individuals with alcohol use disorder (AUD) for confronting alcohol and associated stimuli in real life. CET has shown promise when treating AUD in group sessions, but it is unknown whether progressing from group sessions to using a mobile phone app is an effective delivery pathway.OBJECTIVE: The objectives of this study were to investigate (1) whether CET as aftercare would increase the effectiveness of primary treatment with cognitive behavior therapy, and (2) whether CET delivered through a mobile phone app would be similarly effective to CET via group sessions.METHODS: A total of 164 individuals with AUD were randomized to one of three groups: CET as group aftercare (CET group), CET as fully automated mobile phone app aftercare (CET app), or aftercare as usual. Study outcomes were assessed face-to-face at preaftercare, postaftercare, and again at 6 months after aftercare treatment. Generalized mixed models were used to compare the trajectories of the groups over time on drinking, cravings, and use of urge-specific coping skills (USCS).RESULTS: In all, 153 of 164 individuals (93%) completed assessments both at posttreatment and 6-month follow-up assessments. No differences in the trajectories of predicted means were found between the experimental groups (CET group and app) compared with aftercare as usual on drinking and craving outcomes over time. Both CET group (predicted mean difference 5.99, SE 2.59, z=2.31, P=.02) and the CET app (predicted mean difference 4.90, SE 2.26, z=2.31, P=.02) showed increased use of USCS compared to aftercare as usual at posttreatment, but this effect was reduced at the 6-month follow-up. No differences were detected between the two experimental CET groups on any outcomes.CONCLUSIONS: CET with USCS delivered as aftercare either via group sessions or a mobile phone app did not increase the effectiveness of primary treatment. This suggests that CET with USCS may not be an effective psychological approach for the aftercare of individuals treated for AUD.TRIAL REGISTRATION: ClinicalTrials.gov NCT02298751; https://clinicaltrials.gov/ct2/show/NCT02298751.

AB - BACKGROUND: Cue exposure therapy (CET) is a psychological approach developed to prepare individuals with alcohol use disorder (AUD) for confronting alcohol and associated stimuli in real life. CET has shown promise when treating AUD in group sessions, but it is unknown whether progressing from group sessions to using a mobile phone app is an effective delivery pathway.OBJECTIVE: The objectives of this study were to investigate (1) whether CET as aftercare would increase the effectiveness of primary treatment with cognitive behavior therapy, and (2) whether CET delivered through a mobile phone app would be similarly effective to CET via group sessions.METHODS: A total of 164 individuals with AUD were randomized to one of three groups: CET as group aftercare (CET group), CET as fully automated mobile phone app aftercare (CET app), or aftercare as usual. Study outcomes were assessed face-to-face at preaftercare, postaftercare, and again at 6 months after aftercare treatment. Generalized mixed models were used to compare the trajectories of the groups over time on drinking, cravings, and use of urge-specific coping skills (USCS).RESULTS: In all, 153 of 164 individuals (93%) completed assessments both at posttreatment and 6-month follow-up assessments. No differences in the trajectories of predicted means were found between the experimental groups (CET group and app) compared with aftercare as usual on drinking and craving outcomes over time. Both CET group (predicted mean difference 5.99, SE 2.59, z=2.31, P=.02) and the CET app (predicted mean difference 4.90, SE 2.26, z=2.31, P=.02) showed increased use of USCS compared to aftercare as usual at posttreatment, but this effect was reduced at the 6-month follow-up. No differences were detected between the two experimental CET groups on any outcomes.CONCLUSIONS: CET with USCS delivered as aftercare either via group sessions or a mobile phone app did not increase the effectiveness of primary treatment. This suggests that CET with USCS may not be an effective psychological approach for the aftercare of individuals treated for AUD.TRIAL REGISTRATION: ClinicalTrials.gov NCT02298751; https://clinicaltrials.gov/ct2/show/NCT02298751.

KW - aftercare

KW - alcohol use disorder

KW - cognitive behavior therapy

KW - cue exposure therapy

KW - mobile phone app

KW - randomized controlled trial

U2 - 10.2196/13793

DO - 10.2196/13793

M3 - Journal article

VL - 7

JO - J M I R mHealth and uHealth

JF - J M I R mHealth and uHealth

SN - 2291-5222

IS - 8

M1 - e13793

ER -