A randomized trial testing digital medicine support models for mild-to-moderate alcohol use disorder.

Area of Science:

• Digital medicine
• Health systems research
• Alcohol use disorder treatment

Background:

• Digital interventions offer scalable solutions for managing mild-to-moderate alcohol use disorder (AUD).
• Varying levels of human oversight can impact the effectiveness and implementation of digital health tools.

Purpose of the Study:

• To evaluate the effectiveness of a digital medicine intervention for AUD across different human oversight models.
• To compare self-monitored, peer-supported, and clinically integrated digital health support models.

Main Methods:

• Hybrid effectiveness-implementation randomized trial.
• Three arms: self-monitored (SM), peer-supported (PS), and clinically integrated (CI) digital intervention for AUD.
• 12-month follow-up assessing heavy drinking days, mental health, and quality of life.

Main Results:

• All groups showed a significant reduction in heavy drinking days, from 38.4% at baseline to 22.5% at 12 months.
• The clinically integrated group demonstrated greater improvements in mental health and quality of life compared to self-monitoring.
• Higher attrition rates were observed in the clinically integrated group.

Conclusions:

• A self-guided digital intervention is a viable option for health systems aiming to reduce alcohol risk.
• The optimal level of human oversight for digital AUD interventions requires further investigation.
• Digital medicine shows promise for improving AUD outcomes and patient well-being.