Kelly S DeMartini1, Michael L Schilsky2, Amanda Palmer3, Dwain C Fehon4, Paula Zimbrean4, Stephanie S O'Malley5, Hochang B Lee6, Benjamin A Toll7. 1. Department of Psychiatry, Smilow Cancer Hospital at Yale, Yale School of Medicine, New Haven, Connecticut. 2. Departments of Medicine and Surgery, Divisions of Digestive Diseases and Transplantation and Immunology, Yale-New Transplantation Center, Yale School of Medicine, New Haven, Connecticut. 3. Moffitt Cancer Center, University of South Florida, Tampa, Florida. 4. Liver Transplantation Center, Yale-New Haven Hospital, New Haven, Connecticut. 5. Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut. 6. Department of Psychological Medicine, Yale-New Haven Hospital, New Haven, Connecticut. 7. Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
Abstract
BACKGROUND: Many liver transplantation programs require documented alcohol sobriety prior to United Network for Organ Sharing (UNOS) listing. This pilot study examined the feasibility of the first mobile, alcohol relapse prevention intervention for liver transplant patients with alcoholic liver disease (ALD). METHODS: This was a randomized 8-week pilot feasibility trial of a text message-based alcohol intervention. In-treatment assessment was conducted at 4 weeks (4W), and immediate posttreatment assessment was conducted at 8W. Participants were liver transplant candidates (N = 15) diagnosed with ALD who reported at least 1 drinking episode in the past year. Primary feasibility outcomes were percent of messages responded to and posttreatment intervention satisfaction ratings. Preliminary clinical efficacy outcomes were any biologically confirmed alcohol consumption, stress, abstinence self-efficacy, and alcohol craving. RESULTS: On feasibility outcomes, participants responded to 81% of messages received and reported high rates of intervention satisfaction, looked forward to receiving the messages, and found it easy to complete the intervention. On preliminary efficacy outcomes, zero participants in the text message (TM) had positive urine alcohol tests at 8W. Two of the 6 participants in standard care (SC) tested positive at 8W. No effects were seen on craving. For stress, a condition × time interaction emerged. TM participants had less stress at 4W and 8W compared with SC at baseline. They maintained their stress level during the intervention. For self-efficacy, a trend for condition effect emerged. TM participants had higher self-efficacy than SC participants. CONCLUSIONS: Participants reported high satisfaction with the intervention, looked forward to the messages, and found it easy to complete. Participants who received the intervention had better treatment outcomes than those who received standard care. They maintained higher levels of self-efficacy and lower stress. Mobile alcohol interventions may hold significant promise to help ALD liver transplant patients maintain sobriety.
RCT Entities:
BACKGROUND: Many liver transplantation programs require documented alcohol sobriety prior to United Network for Organ Sharing (UNOS) listing. This pilot study examined the feasibility of the first mobile, alcohol relapse prevention intervention for liver transplant patients with alcoholic liver disease (ALD). METHODS: This was a randomized 8-week pilot feasibility trial of a text message-based alcohol intervention. In-treatment assessment was conducted at 4 weeks (4W), and immediate posttreatment assessment was conducted at 8W. Participants were liver transplant candidates (N = 15) diagnosed with ALD who reported at least 1 drinking episode in the past year. Primary feasibility outcomes were percent of messages responded to and posttreatment intervention satisfaction ratings. Preliminary clinical efficacy outcomes were any biologically confirmed alcohol consumption, stress, abstinence self-efficacy, and alcohol craving. RESULTS: On feasibility outcomes, participants responded to 81% of messages received and reported high rates of intervention satisfaction, looked forward to receiving the messages, and found it easy to complete the intervention. On preliminary efficacy outcomes, zero participants in the text message (TM) had positive urine alcohol tests at 8W. Two of the 6 participants in standard care (SC) tested positive at 8W. No effects were seen on craving. For stress, a condition × time interaction emerged. TM participants had less stress at 4W and 8W compared with SC at baseline. They maintained their stress level during the intervention. For self-efficacy, a trend for condition effect emerged. TM participants had higher self-efficacy than SC participants. CONCLUSIONS:Participants reported high satisfaction with the intervention, looked forward to the messages, and found it easy to complete. Participants who received the intervention had better treatment outcomes than those who received standard care. They maintained higher levels of self-efficacy and lower stress. Mobile alcohol interventions may hold significant promise to help ALD liver transplant patients maintain sobriety.
Authors: Giuseppe Carrà; Cristina Crocamo; Francesco Bartoli; Daniele Carretta; Alessandro Schivalocchi; Paul E Bebbington; Massimo Clerici Journal: J Adolesc Health Date: 2016-05 Impact factor: 5.012
Authors: Caroline Free; Rosemary Knight; Steven Robertson; Robyn Whittaker; Phil Edwards; Weiwei Zhou; Anthony Rodgers; John Cairns; Michael G Kenward; Ian Roberts Journal: Lancet Date: 2011-07-02 Impact factor: 79.321
Authors: Robyn Whittaker; Ralph Maddison; Hayden McRobbie; Chris Bullen; Simon Denny; Enid Dorey; Mary Ellis-Pegler; Jaco van Rooyen; Anthony Rodgers Journal: J Med Internet Res Date: 2008-11-25 Impact factor: 5.428