Telehealth Program for Alcohol Use Disorder Resulted in Medication Utilization and Decreased Drinking

This observational study examined alcohol use disorder (AUD) treatment outcomes for 4121 patients receiving care through a single telehealth program. The program included telehealth encounters with a medical provider (monthly) and recovery coach (weekly), plus at least daily blood alcohol concentration (BAC) measurement through a Bluetooth-enabled breathalyzer. Key outcomes were 90-day treatment retention and changes in daily estimated peak BAC; additional analyses examined outcomes based on sex and drinking goals (i.e., abstinence versus controlled drinking).

• Most patients (85 percent) received medications for AUD.
• 90-day retention was significantly greater for women (52 percent) than men (48 percent).
• Among patients retained for 90 days, BAC decreased from 0.092 (day 1) to 0.038 (day 90). Decreases in BAC were similar for women and men.
• Patients with controlled drinking goals started with higher BACs than those with abstinence goals, but the trajectories of BAC reductions did not differ between groups.

Comments: Despite the limitations inherent in observational studies, these findings are promising in that half of patients seeking telehealth AUD treatment meaningfully engaged in services, most received pharmacotherapy, and those retained in care had large reductions in BAC. In contrast, most people with AUD in the US receive no evidence-based treatment, and those who do are rarely prescribed medications. Future studies should compare telehealth AUD treatment with a control group, and could include outcomes of patient satisfaction and comfort with the telehealth platform. Another research focus could be establishing holistic, patient-centered outcomes that demonstrate the benefits of controlled drinking beyond reductions in BAC or consumption measures.

Aaron D. Fox, MD

Reference: Hallgren KA, Galloway GP, Witkiewitz K, et al. Treatment retention and reductions in blood alcohol concentration (BAC) during the first 90days of a telehealth program for alcohol use disorder. Am J Drug Alcohol Abuse. 2023;49:249–259.