Treatment retention and reductions in blood alcohol concentration (BAC) during the first 90 days of a telehealth program for alcohol use disorder

ABSTRACT

Background: Alcohol use disorder (AUD) treatments, including medications, are increasingly offered via telehealth.

Objective: This study characterizes 90-day treatment retention and changes in objectively measured blood alcohol concentration (BAC) in a large cohort receiving AUD telehealth.

Methods: Patients received AUD treatment through Ria, a virtual (telehealth) program offering AUD treatment that is tailored to patient goals (e.g. abstinence or controlled drinking). Patients were encouraged to complete breathalyzer readings twice daily for measurement-based care. We characterized rates of 90-day treatment retention (i.e. completing a BAC reading or medical/coaching encounter on the 90^th day or later) and used growth curve analyses to model changes in daily estimated peak BAC over 90 days.

Results: Of 4121 patients (51.5% women), 50.1% had 90-day treatment retention (n = 2066, 52.2% women). Most patients received prescriptions for AUD medications (84.6%) and completed encounters with medical providers (86.7%) and coaches (86.1%). Patients with 90-day retention provided 184,817 BAC readings in the first 90 days. Growth curve analyses revealed significant reductions in daily estimated peak BAC (p < .001) from a mean of 0.092 (day 1) to 0.038 (day 90). Similar magnitudes of BAC reduction were observed for men and women and for patients with abstinence and controlled drinking goals.

Conclusion: Telehealth appears to be a viable approach to delivering AUD treatments in a manner that promotes drinking reductions. Telehealth approaches can yield reductions in objectively measured BAC, including for some patient subgroups that have historically faced greater stigma in AUD treatment settings, such as women and people with non-abstinence drinking goals.

KEYWORDS:

• Alcohol use disorder treatment
• breathalyzer
• blood alcohol concentration
• mHealth
• telehealth

Disclosure statement

• Kevin A. Hallgren declares no conflicts of interest.

• Gantt P. Galloway is employed by Ria Health and has been granted equity in Ria Health.

• Katie Witkiewitz is a member Alcohol Clinical Trials Initiative (ACTIVE) Workgroup, which in the past 36 months has had activities that were supported by Alkermes, Dicerna, Ethypharm, Lundbeck, Mitsubishi, and Otsuka.

• Paul Linde is employed by Ria Health and has been granted equity in Ria Health.

• Bob Nix is employed by Ria Health and has been granted equity in Ria Health.

• John E. Mendelson is employed by Ria Health and has been granted equity in Ria Health.

Additional information

Funding

Research reported in this publication was supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) of the National Institutes of Health (NIH) under award numbers R01AA022328 and K01AA024796. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIAAA or the NIH.