This randomized controlled trial examined the impact of daily supportive text messages over a six-month treatment period on mood and alcohol consumption in individuals with a dual diagnosis of alcohol use disorder (AUD) and depression. Results highlighted mood benefits at 3-month and lower alcohol consumption at 6-month treatment points.
<b><i>Background and Aims:</i></b> Alcohol use disorder (AUD) is a substantial problem, causing early death and great economic burden. Research has highlighted the potential positive impact of technological interventions, such as smartphone applications (app) in treatment of AUD. The aim of this study was to explore the effectiveness of a smartphone app, incorporating computerized cognitive behavioural therapy and text messaging support, on alcohol outcomes over 6 months in a post-rehabilitation setting. <b><i>Methods:</i></b> A total of 111 participants with AUD were recruited into this randomized controlled trial, following completion of a 30-day rehabilitation programme. The intervention group (<i>n</i> = 54) used the smartphone app “UControlDrink” (UCD) over 6 months with treatment as usual (TAU), and the control group (<i>n</i> = 57) received TAU. All subjects suffered from AUD as the primary disorder, with other major psychiatric disorders excluded. All intervention subjects used the UCD smartphone app in the treatment trial, and all subjects underwent TAU consisting of outpatient weekly support groups. Drinking history in the previous 90 days was measured at baseline and at 3- and 6-month follow-ups. Additional measurements were made to assess mood, anxiety, craving, and motivation. Results were analysed using intention-to-treat analyses. <b><i>Results:</i></b> Retention in the study was 72% at 3 months and 52% at 6 months. There was a significant reduction in heavy drinking days in the intervention group relative to TAU over the 6 months, <i>p</i> < 0.02. <b><i>Conclusions:</i></b> The UCD smartphone app demonstrates a significant benefit to reducing heavy drinking days over a 6-month post-rehabilitation period in AUD.
Patients with a palliative diagnosis were excluded from this study.Results 87 patients were discharged directly home in the 6 year study period. No patients died within 30 days of discharge. The median PIM 3 score was 0.0139 (IQR 0.0072-0.0347). Of patients admitted diagnoses were 41% Respiratory, 33% Peri-operative, 8% Cardiology, 6% Toxicology, 5% Neurology, 5% Gastrointestinal, 2% Allergy and 1% Trauma. 69 (79%) of patients had a past medical history. In 34 (39%) admissions patients had a tracheostomy. There were no discharges against medical advice. The primary team was informed of discharge for 84 (97%) patients. A documented follow-up plan was recorded for 46 (53%) patients. There was written communication with the patients general practitioner for 22 (25%) patients. 5 (6%) patients were discharged outside the hours of 9:00-17:00. Conclusions For the most part primary teams were informed and the majority of patients had follow-up arranged, however communication with the GP was poor. Following the results of this study a standardised template was introduced at our institution to improve the discharge process.
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