Computer-Based Alcohol Use Disorder Recovery System

Study Overview
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Brief Summary
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The purpose of this grant is to develop and test a proven computer based quality improvement/behavior change e-Health system (CHESS--Comprehensive Health Enhancement Support System) to help prevent relapse in alcohol dependent patients being discharged from residential treatment. The investigators' primary hypothesis is that ACHESS (Addiction CHESS) will improve competence, relatedness and autonomy, which will reduce the days of risky drinking over a 12-month period.

Detailed Description
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The system to be tested (ACHESS - Addiction CHESS) will be delivered through a new modality (smart-phone rather than PC) to make access more widespread, focus on new patients (alcohol dependent patients leaving residential care), offer optional audio delivery to improve access for those who have literacy challenges and be enhanced with services tailored to relapse prevention. ACHESS will offer: 1) communication with peer support groups and addiction experts; 2) timely monitoring to assess risk of relapse, 3) reminders and alerts to encourage adherence to therapeutic goals; 4) addiction-related educational material and tools tailored to the needs of the particular patient, 5) access to selected Internet based resources and 6) communication with a care manager. Patients randomly assigned to ACHESS will learn to use it prior to discharge from residential care.

Official Title
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Developing and Testing a Computer-Based Alcohol Use Disorder Recovery System

Conditions
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Alcohol Dependence

Intervention / Treatment
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* Behavioral: Addiction CHESS


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All subjects must be at least 18 years of age All subjects must be willing to participate in the study All subjects must be willing to identify two people who could provide contact information about their location for the next year If randomized into ACHESS, all subjects must agree to allow monitoring of their ACHESS usage, including internet browsing All subjects must pass a literacy test Exclusion Criteria: Homelessness Psychiatric or medical condition that precludes participation in the study including: subjects with a history of suicidality, significant developmental/cognitive impairments that limit their ability to understand the material or have vision problems will not be included in this study.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: A CHESS<br>Those in the ACHESS arm will also be given a smart-phone with access to the ACHESS system (the intervention) for a full 12 months. The ACHESS intervention includes: 1) the Core CHESS system that has been tested in several diseases, 2) a proactive computer-based relapse prevention system, 3) data transfer from the phone to a computer accessible by the patient's counselor/care manager, and 4) systems for the patient to maintain contact with his/her Care Manager | Behavioral: Addiction CHESS<br>* Smartphone with ACHESS application loaded onto the phone.<br>|
| No Intervention: Usual Care<br>Those randomized into the Usual Care group will receive usual medical care. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ACHESS + standard care will reduce days of risky drinking over the 12-month follow-up period as measured by three interviews. The time-line follow-back techniques will be used'. |  | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ACHESS will reduce proximal outcomes of cravings and negative affect, and produce distal outcomes of increased complete abstinence from alcohol, days of abstinence and reduced negative consequences of substance use. |  | 12 mos. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Alcohol addiction, Alcohol treatment, Alcohol recovery, Post residential treatment DSM-IV diagnosis of alcohol dependence