title: A smartphone application to support recovery from alcoholism: a randomized clinical trial.
abstract: OBJECTIVE
  Patients leaving residential treatment for alcohol use disorders are not typically offered evidence-based continuing care, although research suggests that continuing care is associated with better outcomes. A smartphone-based application could provide effective continuing care.
  
  
  OBJECTIVE
  To determine whether patients leaving residential treatment for alcohol use disorders with a smartphone application to support recovery have fewer risky drinking days than control patients.
  
  
  METHODS
  An unmasked randomized clinical trial involving 3 residential programs operated by 1 nonprofit treatment organization in the Midwestern United States and 2 residential programs operated by 1 nonprofit organization in the Northeastern United States. In total, 349 patients who met the criteria for DSM-IV alcohol dependence when they entered residential treatment were randomized to treatment as usual (n = 179) or treatment as usual plus a smartphone (n = 170) with the Addiction-Comprehensive Health Enhancement Support System (A-CHESS), an application designed to improve continuing care for alcohol use disorders.
  
  
  METHODS
  Treatment as usual varied across programs; none offered patients coordinated continuing care after discharge. A-CHESS provides monitoring, information, communication, and support services to patients, including ways for patients and counselors to stay in contact. The intervention and follow-up period lasted 8 and 4 months, respectively.
  
  
  METHODS
  Risky drinking days--the number of days during which a patient's drinking in a 2-hour period exceeded 4 standard drinks for men and 3 standard drinks for women, with standard drink defined as one that contains roughly 14 g of pure alcohol (12 oz of regular beer, 5 oz of wine, or 1.5 oz of distilled spirits). Patients were asked to report their risky drinking days in the previous 30 days on surveys taken 4, 8, and 12 months after discharge from residential treatment.
  
  
  RESULTS
  For the 8 months of the intervention and 4 months of follow-up, patients in the A-CHESS group reported significantly fewer risky drinking days than did patients in the control group, with a mean of 1.39 vs 2.75 days (mean difference, 1.37; 95% CI, 0.46-2.27; P = .003).
  
  
  CONCLUSIONS
  The findings suggest that a multifeatured smartphone application may have significant benefit to patients in continuing care for alcohol use disorders.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT01003119.
authors.affiliation: Center for Health Enhancement Systems Studies, College of Engineering, University of Wisconsin-Madison.
authors.forename: David H
authors.initials: DH
authors.lastname: Gustafson
authors.affiliation: Center for Health Enhancement Systems Studies, College of Engineering, University of Wisconsin-Madison.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: McTavish
authors.affiliation: Center for Health Enhancement Systems Studies, College of Engineering, University of Wisconsin-Madison.
authors.forename: Ming-Yuan
authors.initials: MY
authors.lastname: Chih
authors.affiliation: Center for Health Enhancement Systems Studies, College of Engineering, University of Wisconsin-Madison.
authors.forename: Amy K
authors.initials: AK
authors.lastname: Atwood
authors.affiliation: Center for Health Enhancement Systems Studies, College of Engineering, University of Wisconsin-Madison.
authors.forename: Roberta A
authors.initials: RA
authors.lastname: Johnson
authors.affiliation: Center for Health Enhancement Systems Studies, College of Engineering, University of Wisconsin-Madison.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Boyle
authors.affiliation: North Shore Medical Center, Salem, Massachusetts.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Levy
authors.affiliation: Fayette Companies, Peoria, Illinois.
authors.forename: Hilary
authors.initials: H
authors.lastname: Driscoll
authors.affiliation: North Shore Community College, Lynn, Massachusetts.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Chisholm
authors.affiliation: Center for Health Enhancement Systems Studies, College of Engineering, University of Wisconsin-Madison.
authors.forename: Lisa
authors.initials: L
authors.lastname: Dillenburg
authors.affiliation: Center for Health Enhancement Systems Studies, College of Engineering, University of Wisconsin-Madison.
authors.forename: Andrew
authors.initials: A
authors.lastname: Isham
authors.affiliation: Mass Communications Research Center, School of Journalism and Mass Communication, University of Wisconsin-Madison.
authors.forename: Dhavan
authors.initials: D
authors.lastname: Shah
mesh_terms: D000328:Adult; D000359:Aftercare; D000437:Alcoholism / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation*; D019090:Case Management; D040421:Cell Phone; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D062405:Motivational Interviewing; D010349:Patient Compliance / Q000523:psychology; D010353:Patient Education as Topic; D026684:Personal Autonomy; D011615:Psychotherapy, Group; D055502:Secondary Prevention; D012984:Software; D016320:Substance Abuse Treatment Centers; D013695:Temperance / Q000523:psychology; D013813:Therapy, Computer-Assisted