Use of Transdermal Alcohol Sensors in Conjunction With Contingency Management to Reduce Alcohol Consumption in People With Alcohol Dependence Attending Alcohol Treatment Services: Protocol for a Pilot Feasibility Randomized Controlled Trial

Overview

Journal JMIR Res Protoc

Publisher JMIR Publications

Specialty General Medicine

Date 2024 Jul 31

PMID 39083798

Authors

Eileen Brobbin

Paolo Deluca

Stephen Parkin

Colin Drummond

Affiliations

Soon will be listed here.

Abstract

Background: Wearable technology for objective, continuous, and reliable alcohol monitoring has been developed. These are known as transdermal alcohol sensors (TASs). They can be worn on the wrist or ankle with the sensor pressed against the skin and can measure sweat vapors being emitted from the skin, to record transdermal alcohol concentration (TAC). Previous studies have investigated the accuracy and acceptability of the available TAS brands, but there has been little research into their use in people with alcohol use disorders (AUD).

Objective: This feasibility randomized controlled trial aims to explore the feasibility, strengths, and limitations of using a TAS to monitor alcohol consumption in individuals in treatment for AUD with or without contingency management (CM) to promote abstinence or low-level alcohol consumption.

Methods: The target sample size is 30 (15 randomized to each group). Participants will be recruited through poster adverts at alcohol services. Both groups (control and CM) will wear the TAS (BACtrack Skyn) for 2 weeks in the context of their usual treatment, meeting with the researcher every other weekday. In the last meeting, the participants will complete a postwear survey on their experience of wearing the TAS. The CM group will also receive small financial incentives for low or no alcohol consumption, as measured by the TAS. On days where the TAC peak is below a set threshold (<115.660 g/L), CM group participants will be rewarded with a £5 (US $6.38) voucher. There are financial bonuses if this target is achieved on consecutive days. The researcher will monitor TAC for each day of the study at each research visit and allocate financial incentives to participants according to a set reinforcement schedule.

Results: The first participant was enrolled in June 2023, and the last in December 2023. Data analysis is underway and is estimated to be completed by June 2024. A total of 32 participants were enrolled.

Conclusions: Most TAS brands have had limited application in clinical settings, and most studies have included healthy adults rather than people with AUD. TAS has the potential to enhance treatment outcomes in clinical alcohol treatment. The accuracy, acceptability, and feasibility of TAS for people with AUD in clinical settings need to be investigated. This is the first study to use TAS in specialized alcohol services with diagnosed AUD individuals currently receiving treatment from a south London alcohol service.

Trial Registration: ISRCTN Registry ISRCTN46845361; https://www.isrctn.com/ISRCTN46845361.

International Registered Report Identifier (irrid): DERR1-10.2196/57653.

References

Garnett C, Crane D, West R, Brown J, Michie S . Identification of Behavior Change Techniques and Engagement Strategies to Design a Smartphone App to Reduce Alcohol Consumption Using a Formal Consensus Method. JMIR Mhealth Uhealth. 2015; 3(2):e73. PMC: 4526967. DOI: 10.2196/mhealth.3895. View

Hertzog M . Considerations in determining sample size for pilot studies. Res Nurs Health. 2008; 31(2):180-91. DOI: 10.1002/nur.20247. View

Schmier J, Halpern M . Patient recall and recall bias of health state and health status. Expert Rev Pharmacoecon Outcomes Res. 2009; 4(2):159-63. DOI: 10.1586/14737167.4.2.159. View

Rosenberg M, Kianersi S, Luetke M, Jozkowski K, Guerra-Reyes L, Shih P . Wearable alcohol monitors for alcohol use data collection among college students: Feasibility and acceptability. Alcohol. 2023; 111:75-83. PMC: 10527594. DOI: 10.1016/j.alcohol.2023.05.007. View

Drake R, ONeal E, Wallach M . A systematic review of psychosocial research on psychosocial interventions for people with co-occurring severe mental and substance use disorders. J Subst Abuse Treat. 2007; 34(1):123-38. DOI: 10.1016/j.jsat.2007.01.011. View

Alessi S, Petry N . A randomized study of cellphone technology to reinforce alcohol abstinence in the natural environment. Addiction. 2013; 108(5):900-9. PMC: 3662495. DOI: 10.1111/add.12093. View

Courtney J, Russell M, Conroy D . Acceptability and validity of using the BACtrack skyn wrist-worn transdermal alcohol concentration sensor to capture alcohol use across 28 days under naturalistic conditions - A pilot study. Alcohol. 2022; 108:30-43. PMC: 10413177. DOI: 10.1016/j.alcohol.2022.11.004. View

Lancaster G, Dodd S, Williamson P . Design and analysis of pilot studies: recommendations for good practice. J Eval Clin Pract. 2004; 10(2):307-12. DOI: 10.1111/j..2002.384.doc.x. View

Petry N . A comprehensive guide to the application of contingency management procedures in clinical settings. Drug Alcohol Depend. 2000; 58(1-2):9-25. DOI: 10.1016/s0376-8716(99)00071-x. View

10.

Averill F, Brown T, D Robertson R, Tchomgang A, Berbiche D, Nadeau L . Transdermal alcohol monitoring combined with contingency management for driving while impaired offenders: A pilot randomized controlled study. Traffic Inj Prev. 2018; 19(5):455-461. DOI: 10.1080/15389588.2018.1448079. View

11.

Wang Y, Fridberg D, Leeman R, Cook R, Porges E . Wrist-worn alcohol biosensors: Strengths, limitations, and future directions. Alcohol. 2018; 81:83-92. PMC: 6395541. DOI: 10.1016/j.alcohol.2018.08.013. View

12.

Oluwoye O, Reneau H, Herron J, Alcover K, McPherson S, Roll J . Pilot Study of an Integrated Smartphone and Breathalyzer Contingency Management Intervention for Alcohol Use. J Addict Med. 2019; 14(3):193-198. PMC: 7075732. DOI: 10.1097/ADM.0000000000000553. View

13.

Dutra L, Stathopoulou G, Basden S, Leyro T, Powers M, Otto M . A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry. 2008; 165(2):179-87. DOI: 10.1176/appi.ajp.2007.06111851. View

14.

McPhail S, Haines T . Response shift, recall bias and their effect on measuring change in health-related quality of life amongst older hospital patients. Health Qual Life Outcomes. 2010; 8:65. PMC: 2912788. DOI: 10.1186/1477-7525-8-65. View

15.

Mathias C, Hill-Kapturczak N, Karns-Wright T, Mullen J, Roache J, Fell J . Translating transdermal alcohol monitoring procedures for contingency management among adults recently arrested for DWI. Addict Behav. 2018; 83:56-63. PMC: 5964006. DOI: 10.1016/j.addbeh.2018.01.033. View

16.

Kilmer B, Nicosia N, Heaton P, Midgette G . Efficacy of frequent monitoring with swift, certain, and modest sanctions for violations: insights from South Dakota's 24/7 Sobriety Project. Am J Public Health. 2012; 103(1):e37-43. PMC: 3518350. DOI: 10.2105/AJPH.2012.300989. View

17.

Villalba K, Cook C, Devieux J, Ibanez G, Oghogho E, Neira C . Facilitators and barriers to a contingency management alcohol intervention involving a transdermal alcohol sensor. Heliyon. 2020; 6(3):e03612. PMC: 7103775. DOI: 10.1016/j.heliyon.2020.e03612. View

18.

Browne R . On the use of a pilot sample for sample size determination. Stat Med. 1995; 14(17):1933-40. DOI: 10.1002/sim.4780141709. View

19.

Brobbin E, Deluca P, Coulton S, Drummond C . Accuracy of transdermal alcohol monitoring devices in a laboratory setting. Alcohol Alcohol. 2023; 59(1). DOI: 10.1093/alcalc/agad068. View

20.

McDonell M, Leickly E, McPherson S, Skalisky J, Srebnik D, Angelo F . A Randomized Controlled Trial of Ethyl Glucuronide-Based Contingency Management for Outpatients With Co-Occurring Alcohol Use Disorders and Serious Mental Illness. Am J Psychiatry. 2017; 174(4):370-377. PMC: 5378651. DOI: 10.1176/appi.ajp.2016.16050627. View