Randomized controlled trial of a smartphone app designed to reduce unhealthy alcohol consumption

TL;DR

A smartphone app helped reduce weekly alcohol consumption more than an educational-only version, but had no effect on heavy drinking or alcohol-related problems.

Contribution

A randomized controlled trial demonstrated that a smartphone app can modestly reduce unhealthy alcohol consumption in a general population.

Findings

Participants using the full app reduced their weekly alcohol consumption more than those using the educational-only app.

No significant differences were found in heavy drinking days or alcohol-related problems between the two app versions.

This is the second trial showing effectiveness of the app in reducing unhealthy alcohol use.

Abstract

Unhealthy alcohol use is common and causes tremendous harm. Most people with unhealthy alcohol use will never seek formal alcohol treatment. As an alternative, smartphone apps have been developed as one means to provide help to people concerned about their alcohol use. The aim of this study was to test the efficacy of a smartphone app targeting unhealthy alcohol consumption in a general population sample.

Participants were recruited from across Canada using online advertisements. Eligible participants who consented to the trial were asked to download a research-specific version of the app and were provided with a code that unlocked it (a different code for each participant to prevent sharing). Those who entered the code were randomized to one of two different versions of the app: 1) the Full app containing all intervention modules; or 2) the Educational only app, containing only the educational content of the app. Participants were followed-up at 6 months. The primary outcome variable was number of standard drinks in a typical week. Secondary outcome variables were frequency of heavy drinking days and experience of alcohol-related problems.

A total of 761 participants were randomized to a condition. The follow-up rate was 81 %. A generalized linear mixed model revealed that participants receiving the full app reduced their typical weekly alcohol consumption to a greater extent than participants receiving the educational only app (incidence rate ratio 0.89; 95 % confidence interval 0.80 to 0.98). No significant differences were observed in the secondary outcome variables (p > .05).

The results of this trial provide some supportive evidence that smartphone apps can reduce unhealthy alcohol consumption. As this is the second randomized controlled trial demonstrating an impact of this same app (the first one targeted unhealthy alcohol use in university students), increased confidence is placed on the potential effectiveness of the smartphone app employed in the current trial.

ClinicalTrials.org number: NCT04745325

•A smartphone app designed for people concerned with their alcohol use was compared to one with only educational material•Change in drinks per week, heavy drinking days, and alcohol-related problems were compared 6-months after receiving the app•Greater reduction in drinks per week among the full app compared to education only version; no other significant differences

A smartphone app designed for people concerned with their alcohol use was compared to one with only educational material

Change in drinks per week, heavy drinking days, and alcohol-related problems were compared 6-months after receiving the app

Greater reduction in drinks per week among the full app compared to education only version; no other significant differences

Figures