Effect of a 1‐year short message service in detoxified alcohol‐dependent patients: a multi‐center, open‐label randomized controlled trial

• Published in: Addiction (Abingdon, England) Vol. 116; no. 6; pp. 1431 - 1442
• Main Authors: Lucht, Michael, Quellmalz, Anne, Mende, Meinhard, Broda, Anja, Schmiedeknecht, Anett, Brosteanu, Oana, Höppner‐Buchmann, Jacqueline, Langosch, Jens, Stuppe, Markus, Schomerus, Georg, Klauer, Thomas, Grabe, Hans J., Freyberger, Harald J., John, Ulrich, Meyer, Christian
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.06.2021
• Subjects: Abstinence; Alcohol; Alcohol dependence; alcohol detoxification; Alcohol use; Alcoholism; Cellular telephones; Clinical trials; Community hospitals; continuous care; Detoxification; Drinking behavior; Drug dependence; High risk; Inpatient care; Intervention; mHealth; Mobile phones; Patients; short message service (SMS); Telemedicine; Germany; mHealth; short message service (SMS); telemedicine; Alcohol dependence; alcohol detoxification; continuous care
• ISSN: 0965-2140; 1360-0443
• DOI: 10.1111/add.15313

Background and Aims Existing evidence suggests that text message interventions can help people to reduce their alcohol consumption. However, studies with alcohol‐dependent patients are lacking. In this study a 1‐year automatic mobile phone‐based short messaging service (SMS) intervention on alcohol consumption in patients after alcohol detoxification in hospital was compared with treatment as usual. Design Multi‐center, randomized, controlled, two parallel‐group, observer‐blinded trial. Setting and Participants Primary and secondary care: four hospitals and community (1 million residents, 7600 km2 area in Germany). A total of 462 patients with alcohol dependence (ICD‐10) were included during inpatient detoxification treatment. Patients were randomly assigned (1 : 1) to an SMS intervention and treatment as usual (SMS + TAU; n = 230; mean age: 45.4 years; 22.6% women) or TAU alone (n = 232 mean age: 44.5 years; 22.8% women). Planned, automated messages were sent to patients over 1 year to record assistance needs. A ‘yes’ or missing response triggered a telephone call from a hospital therapist. Outcome was assessed by an independent survey center. Measurements The primary end‐point was a three‐category alcohol consumption measure covering months 10–12 after discharge: abstinence, non‐heavy drinking, heavy drinking [men > 60 g/day; women > 40 g/day equal to World Health Organization (WHO) criteria: high risk and very high risk, mean consumption]. Secondary end‐points were number of abstinent days over 12 months and frequency of abstinence. Results The arms differed primarily in the heavy drinking category (intervention group 22.2%, TAU‐only group 32.3%) in months 9–12. This is reflected by an odds ratio (OR) = 1.68, 95% confidence interval (CI) = 1.11–2.54, P = 0.015 for heavy drinking versus non‐heavy drinking/abstinence. No difference between treatments was found with respect to any drinking versus abstinence (OR = 1.13). These results were confirmed by models adjusting for randomization strata. Conclusions In Germany, a 12‐month mobile phone short messaging service‐based intervention enhanced the reduction in heavy drinking for 1 year in routine care among adults with alcohol dependence discharged from inpatient alcohol detoxification.