Academic journal article Alcohol Research: Current Reviews

Mobile Delivery of Treatment for Alcohol Use Disorders: A Review of the Literature

Academic journal article Alcohol Research: Current Reviews

Mobile Delivery of Treatment for Alcohol Use Disorders: A Review of the Literature

Article excerpt

The advent of mobile-phone technology has been one of the most influential technological advances in world history. In 2014, the International Telecommunications Union (ITU) estimated that the number of mobile-phone subscriptions worldwide (including both personal and business subscriptions) would reach about 7.0 billion at the end of 2014 and thus approach the number of people on Earth (corresponding to a global penetration rate of 96 percent) (ITU 2014). Furthermore, Google's "Our Mobile Planet"--a marketing survey commissioned by Google to assess worldwide use of mobile technology--indicated that the use of smartphones (i.e., mobile phones with computer-like capabilities) has increased significantly in recent years (Google, Inc. 2013). According to the survey, more than 50 percent of the population in most developed countries used smartphones in 2013, and rates of smartphone ownership have been increasing steadily year after year. In addition to their many other uses, mobile phones offer an opportunity to monitor various behaviors of their users, such as alcohol consumption, and to deliver interventions to users in near-real time and in the individual's natural environment. Several review and commentary articles about the use of mobile health (mHealth) and Internet technology in health care, and specifically in the treatment of alcohol use disorders (AUDs), have been published in recent years (Bewick et al. 2008; Carey et al. 2009; Gustafson et al. 2011, 2014; Hester and Miller 2006; Kypri et al. 2005; Savic et al. 2013).

A plethora of research supports the conceptualization of addiction as a chronic, relapsing disease (Bradizza et al. 2006; Brownell et al. 1986; Dennis et al. 2003; Donovan 1996; Lowman et al. 1996; McKay and Weiss 2001; McLellan 2002; Mueller et al. 2007; Witkiewitz and Marlatt 2004). As with other chronic diseases, patient self-management and continuing care are fundamental to effective treatment (Wagner et al. 1996). Although research supports the effectiveness of continuing care in addiction treatment (McKay 2005; McLellan et al. 2005; Simpson 2004), the field historically has offered little ongoing support to patients, whether during treatment when the patient is outside of the clinic walls or after the patient has completed treatment (McLellan et al. 2000; White et al. 2002). Mobile technology may make it possible to provide both self-management help and continuing care more widely.

This article explores the following questions about mobile applications intended for patients dealing with AUDs:

* What mHealth applications to treat AUDs exist that have been evaluated in the peer-reviewed literature and how can they be categorized?

* What are common features of these applications?

* How effective are currently commercially available mHealth applications for AUDs?

* What are the characteristics, benefits, and limitations of mHealth applications for AUDs?

* What is the theoretical grounding underlying these applications?

* What are the challenges and opportunities facing mHealth approaches for AUDs?

By design, this discussion is limited to systems that (1) use mobile technology (i.e., do not rely solely on Web-based approaches); (2) focus on AUDs and not on tobacco or other drugs; and (3) have been evaluated in the peer-reviewed literature.

Identifying mHealth Applications to Treat AUDs

To identify mobile applications for AUDs, the authors of this article searched electronic databases of the peer-reviewed research literature. (1) To further identify relevant studies, they also examined the reference lists of the initially retrieved studies. Because the field is changing so rapidly and the discussion should focus on the current state, the initial search only included studies and reports published since 2009.

A subsequent expansion of the search to studies published in earlier years (i. …

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