Abstract
Background and Aims
Existing evidence suggests that text message interventions can help people reduce their alcohol consumption. However, studies with alcohol dependent patients are lacking. In this study a 1‐year automatic mobile phone‐based short messaging service (SMS) intervention on alcohol consumption in patients after alcohol detoxification in hospital was compared with treatment as usual.
Design
Multicenter, randomized, controlled, 2 parallel‐group, observer‐blinded trial
Setting
Primary and secondary care: 4 hospitals and community (1 million residents, 7600 km2 area in Germany).
Participants
A total of 462 patients with alcohol‐dependence (ICD‐10) were included during inpatient detoxification treatment. Patients were randomly assigned (1:1) to an SMS intervention and treatment as usual (SMS+TAU; n=230; mean age: 45.4 years; 22.6% women) or TAU alone (n=232 mean age: 44.5 years; 22.8% women).
Interventions
Planned, automated messages were sent to patients over 1 year to record assistance needs. A “Yes” or missing response triggered a phone call from a hospital therapist. Outcome was assessed by an independent survey center.
Measurements
The primary endpoint was a 3‐category alcohol consumption measure covering months 10‐12 after discharge: abstinence, non‐heavy drinking, heavy drinking (men >60 g/d; women >40 g/d equal to WHO criteria: high risk and very high risk, mean consumption). Secondary endpoints were number of abstinent days over 12 months and frequency of abstinence.
Findings
The arms differed primarily in the heavy drinking category (intervention group 22.2%, TAU‐only group 32.3%) in months 9 to 12. This is reflected by an odds ratio (OR) 1.68, 95%CI 1.11 to 2.54, p = 0.015 for heavy drinking vs. non‐heavy drinking/abstinence. No difference between treatments was found with respect to any drinking vs. abstinence (OR=1.13). These results were confirmed by models adjusting for randomisation strata.
Conclusions
In Germany, a 12 month mobile phone short messaging service‐based intervention enhanced the reduction in heavy drinking for 1 year in routine care among adults with alcohol dependence discharged from inpatient alcohol detoxification.