Telephone‐ and Text Message–Based Continuing Care After Residential Treatment for Alcohol Use Disorder: A Randomized Clinical Multicenter Study

Abstract

Background Alcohol use disorder (AUD) is characterized by extremely high rates of postresidential treatment relapse, and as such, continuing care to prevent relapse has become an important element in AUD treatment. In this regard, research has yielded heterogeneous evidence on telephone‐based (TEL) and text message–based (TEX) continuing care. We aimed to compare the effectiveness of TEL and TEX continuing care provided in different frequencies by psychotherapists for patients from residential treatments in mitigating the occurrence of posttreatment relapse in patients who completed a 12‐week abstinence‐oriented residential treatment program for AUD. Methods A total of 240 patients from 2 residential treatment programs for AUD were included in the study. Patients were randomly assigned to high‐ (10 contacts) or low‐frequency (3 contacts) TEL, TEX (10 contacts) continuing care, or control group (1 contact) from discharge to 6‐month follow‐up. The TEL was intended to be supportive and consisted of several cognitive behavioral therapy components, whereas the TEX was based on behavioral self‐monitoring techniques and additional calls in case of relapse or as needed. Sociodemographic, clinical, and alcohol‐specific variables at residential treatment discharge and at 5‐month follow‐up were assessed through interviews and questionnaires. Results Compared with the control group, patients in the high‐frequency TEL were significantly more likely to be abstinent at 6‐month follow‐up and, in case of relapse, showed a tendency toward a longer time to first drink. Moreover, the high‐frequency TEL and TEX groups had significantly higher alcohol‐related self‐efficacy 6 months after residential treatment. Conclusion High‐frequency proactive telephone contact by psychotherapists known to the patient may help patients to surmount the vulnerable phase after residential treatment and, in case of relapse, might help patients stay connected to health services, which in turn prevents chronification and facilitates recovery from AUD.

Leveraging mHealth and Wearable Sensors to Manage Alcohol Use Disorders: A Systematic Literature Review

“…Of the 25 studies, 14/25 (56%) used an mHealth app, 4/25 (16%) used telephone or interactive voice response, 3/25 (12%) used mHealth serious games or cognitive training delivered on mobile devices, and four studies used either mHealth SMS or mHealth + telephone (2/26 each, 8%). Of the 25 studies analyzed over a 10-year period, 2 were from 2012 [ 17 , 18 ], 1 was from 2013 [ 19 ], 2 were from 2014 [ 20 , 21 ], 1 was from 2015 [ 22 ], 3 were from 2016 [ 23 , 24 , 25 ], 4 were from 2017 [ 26 , 27 , 28 , 29 ], 2 were from 2019 [ 30 , 31 ], and 2020 [ 32 , 33 ], 4 were from 2021 [ 34 , 35 , 36 , 37 ], and 2022 [ 38 , 39 , 40 , 41 ]. Zero studies were from 2018.…”

“…Five themes and three individual observations were identified by the reviewers for a total of 68 occurrences in the literature. Reduction in consumption was identified in 15/31 (48%) of the occurrences [ 18 , 23 , 26 , 27 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. In 10/31 (32%) of the occurrences, the reduction was statistically significant, but in 5/31 (15%) of the occurrences, it was not statistically significant [ 21 , 22 , 29 , 31 , 33 ].…”

“…Two interventions were highlighted as low cost [ 17 , 18 ]. Two interventions resulted in sustained abstinence from drinking [ 34 , 35 ]. One intervention was noted as exceptionally good at providing education about AUD and healthy habits [ 24 ].…”

“…Almost every intervention would require additional teaching of users and provider teams to work with it. This theme occurred 22/34 (65%) occurrences [ 17 , 18 , 20 , 23 , 24 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. In 4/34 (12%) occurrences, it was highlighted that the intervention was equally as effective at managing AUD as the traditional treatment methods, so change may not be necessary [ 21 , 22 , 29 , 31 ].…”

“…Overall, mHealth apps mostly resulted in a reduction in alcohol consumption or a reduction in cravings [ 17 , 18 , 19 , 20 , 24 , 26 , 28 , 30 , 33 , 36 , 37 , 38 , 39 , 41 ]. The mHealth + telephone interventions had the same effect [ 35 , 40 ]. The mHealth SMS interventions had mixed results: They both reduced consumption of alcohol, but only one was a statistically significant decrease [ 22 , 23 ].…”