Mixed-methods trial of a phosphatidylethanol-based contingency management intervention to initiate and maintain alcohol abstinence in formerly homeless adults with alcohol use disorders

Fraser, Elizabeth; Hill‐Kapturczak, Nathalie; Jett, Julianne D.; Beck, Rachael; Oluwoye, Oladunni; Kriegel, Liat; Alcover, Karl C.; McPherson, Sterling; Cabassa, Leopoldo J.; Javors, Martin A.; McDonell, Michael G.

doi:10.1016/j.conctc.2021.100757

Cited by 5 publications

(6 citation statements)

References 69 publications

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“…In several studies with collectives of patients with liver disease, 1 in detoxification clinics 39 . and patients with unhealthy alcohol use, 36 sex was reported not to influence the diagnostic performance of PEth 16:0/18:1. In Hahn et al's study, 36 PEth sensitivity was calculated against score of the Audit‐C, which implemented different cutoffs for men and women, thus excluding the sex difference.…”

Section: Discussionmentioning

confidence: 94%

“…In addition, the usage of ethanol‐containing hygiene products in the studies of Reisfield was very intense. For a cutoff of 20 ng/ml, there have been no reports of clinical false positive cases, and it has been dismissed that incidental alcohol exposure can raise PEth concentration >20 ng/ml 33 . Stöth et al recently conducted a study in which six women consumed between 13.8 and 30.1 g and six men between 20.0 and 45.3 of alcohol in a single drinking event 34 .…”

Section: Discussionmentioning

confidence: 99%

“…For a cutoff of 20 ng/ml, there have been no reports of clinical false positive cases, and it has been dismissed that incidental alcohol exposure can raise PEth concentration >20 ng/ml. 33 Stöth et al recently conducted a study in which six women consumed between 13.8 and 30.1 g and six men between 20.0 and 45.3 of alcohol in a single drinking event. 34 In multiple subsequent blood samplings and analyses, PEth 16:0/18:1 and 16:0/18:2 never exceeded 20 ng/ml.…”

Section: Cutoffsmentioning

confidence: 99%

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PEth 16:0/18:1 and 16:0/18:2 after consumption of low doses of alcohol—A contribution to cutoff discussion

Aboutara

Jungen

Szewczyk

et al. 2022

Drug Testing and Analysis

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Phosphatidylethanol in blood has gained recognition as a direct alcohol biomarker. Although different cutoffs have been suggested, there is no consensus for differentiating abstinence from alcohol consumption. In this study, 75 participants (72% female) consumed 20 g of ethanol on three consecutive evenings. Blood was sampled on each following day and PEth 16:0/18:1 and 16:0/18:2 were determined. PEth 16:0/18:1 ranged from 8.9–21.5, 8.7–19.3, and 8.8–42.3 ng/ml and PEth 16:0/18:2 from 8.7–31.7, 9.0–39.3, and 9.4–43.0 ng/ml after the respective days of ethanol consumption. PEth 16:0/18:1 yielded a sensitivity of 25%, 45%, and 49% and PEth 16:0/18:2 of 40%, 61%, and 68% for the consumption days, respectively (cutoff 10 ng/ml). PEth 16:0/18:1 reached >20 ng/ml in five samples overall. Sensitivity of PEth 16:0/18:2 > 20 ng/ml was better with 35% after the three drinking days. Overall, PEth 16:0/18:1 was >35 ng/ml in one sample and PEth 16:0/18:2 in three samples. Significantly, more women had PEth 16:0/18:1 > 10 ng/ml after the third day of consuming 20 g of alcohol (p = 0.02) and PEth 16:0/18:2 > 10 ng/ml after the second (p = 0.023) and the third (p = 0.002) consumption, which can be led back to the higher blood alcohol concentration women reach after consuming the same alcohol amount as men. Although the response rates of PEth to alcohol uptake are subject to strong interindividual differences, results suggest that PEth cutoff should be lowered for better detection of consumption of low to medium amounts of alcohol. Furthermore, it is advantageous to analyze both PEth 16:0/18:2 and 16:0/18:1.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Cutoffsmentioning

confidence: 99%

See 1 more Smart Citation

PEth 16:0/18:1 and 16:0/18:2 after consumption of low doses of alcohol—A contribution to cutoff discussion

Aboutara

Jungen

Szewczyk

et al. 2022

Drug Testing and Analysis

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“…In the CM study (originally described by Fraser et al, 2021), participants that were randomized to the CM condition took part in three qualitative interviews at their week 4, 26, and 38 visits. The interviews focused on participant beliefs about the CM intervention, as well as acceptability of self-collection using the TASSO-M20 device.…”

Section: Interviews Regarding Acceptability Of the Blood Drawsmentioning

confidence: 99%

“…Given the benefits of using PEth as a biomarker of recent alcohol use (i.e., long detection window, validated analytical methods), a protocol was developed to test a behavioral contingency management (CM) intervention in which tangible reinforcers were provided in exchange for PEth confirmed abstinence (Fraser et al, 2021). For the original plan of the intervention study, research staff were to collect DBS samples in person via finger stick.…”

Section: Introductionmentioning

confidence: 99%

Validation of the quantification of phosphatidylethanol 16:0/18:1 concentrations in TASSO‐M20 devices

Jett

Beck

Tyutyunnyk

et al. 2023

Alcohol: Clinical and Experimental Research

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Background Phosphatidylethanol 16:0/18:1 (PEth), found in whole blood, is a biomarker for alcohol consumption with high sensitivity, specificity, and a long detection window. The TASSO‐M20 device is used to self‐collect capillary blood from the upper arm and has advantages over finger stick methods. The purpose of this study was to (1) validate PEth measurement using the TASSO‐M20 device, (2) describe the TASSO‐M20 for blood self‐collection during a virtual intervention, and (3) characterize PEth, urinary ethyl glucuronide (uEtG) and self‐reported alcohol in a single participant over time. Methods PEth levels in blood samples dried on TASSO‐M20 plugs were compared to those in (1) liquid whole blood (N = 14) and (2) dried blood spot cards (DBS; N = 23). Additionally, the self‐reported drinking, positive or negative uEtG results (dip card cutoff ≥300 ng/mL), and observed self‐collection of blood with TASSO‐M20 devices for PEth levels were obtained over time during virtual interviews of a single contingency management participant. High‐performance liquid chromatography with tandem mass spectrometry detection was used to measure PEth levels for both preparations. Results PEth concentrations from dried blood on TASSO‐M20 plugs and liquid whole blood were correlated (0 to 1700 ng/mL; N = 14; r2 = 0.988; slope = 0.951) and in a subgroup of samples with lower concentrations (N = 7; 0 to 200 ng/mL; r2 = 0.944, slope = 0.816). PEth concentrations from dried blood on TASSO‐M20 plugs and DBS were correlated (0 to 2200 ng/mL; N = 23; r2 = 0.927; slope = 0.667) and in a subgroup of samples with lower concentrations (N = 16; 0 to 180 ng/mL; r2 = 0.978, slope = 0.749). Results of the contingency management participant indicate that changes in PEth levels (TASSO‐M20) and uEtG concentrations were consistent with each other and with changes in self‐reported alcohol use. Conclusions Our data support the utility, accuracy, and feasibility of using the TASSO‐M20 device for blood self‐collection during a virtual study. The TASSO‐M20 device had multiple advantages over the typical finger stick method, including consistent blood collection, participant acceptability, and less discomfort as indicated by acceptability interviews.

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Contingency management with stepped care for unhealthy alcohol use among individuals with HIV: Protocol for a randomized controlled trial

Edelman

Dziura

Deng

et al. 2023

Contemporary Clinical Trials

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Mixed-methods trial of a phosphatidylethanol-based contingency management intervention to initiate and maintain alcohol abstinence in formerly homeless adults with alcohol use disorders

Cited by 5 publications

References 69 publications

PEth 16:0/18:1 and 16:0/18:2 after consumption of low doses of alcohol—A contribution to cutoff discussion

PEth 16:0/18:1 and 16:0/18:2 after consumption of low doses of alcohol—A contribution to cutoff discussion

Validation of the quantification of phosphatidylethanol 16:0/18:1 concentrations in TASSO‐M20 devices

Contingency management with stepped care for unhealthy alcohol use among individuals with HIV: Protocol for a randomized controlled trial

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