Feasibility, Acceptability, and Preliminary Outcomes of an Integrated Telemedicine Intervention Combining Naltrexone and Cognitive Behavioral Therapy for Alcohol Use Disorder

Abstract

Background: A small fraction of individuals in need of treatment for alcohol use disorders (AUDs) seek care, owing largely to barriers to accessing treatment. In the present pilot study, we examine the feasibility, acceptability, and preliminary outcomes of an m-health intervention combining cognitive behavioral therapy and pharmacotherapy for individuals with AUD. Methods: Adults with AUD (N?=?26) recruited through online, social media-based advertising were enrolled in a 12-week, integrated telemedicine intervention combining psychosocial treatment with medical management: Quit Genius for AUD (QG-A). Feasibility, acceptability, perceived helpfulness, treatment engagement, retention, completion, and clinical outcomes including alcohol use and secondary mental health outcomes were assessed. Results: Participants found the QG-A intervention to be acceptable and helpful in facilitating action toward their therapeutic goals concerning alcohol use. Treatment completion, achieved by the majority (85%) of participants, was excellent. On average, participants reduced their past 30-day alcohol use from baseline (mean proportion of days of abstinent?=?0.13) to follow-up (M?=?0.59), t(19)?=??4.97, p?<?0.001, and consumed fewer drinks per drinking day from baseline (M?=?6.7) to follow-up (M?=?2.0), t(19)?=?3.61, p?<?0.001. Concurrently, reductions were observed in depressive (t[22]?=?5.39, p?<?0.001) and anxiety (t[22]?=?2.87, p?<?0.01) symptom severity, from the moderately severe range at baseline to the mild range at treatment-end, with increases in resilience (t[22]?=??3.54, p?<?0.001). Conclusions: Addressing AUDs using an integrated m-health intervention to deliver evidence-based psychosocial and pharmacological treatment is feasible and may produce improvements in both alcohol use and psychiatric symptoms.

Keywords

• cognitive behavioral therapy
• alcohol use disorder
• naltrexone
• m-health