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      An E-Health Solution for People With Alcohol Problems

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          Abstract

          Self-management of chronic diseases has been a research focus for years. Information and communication technologies (ICTs) have played a significant role in aiding patients and their families with that management task. The recent dramatic increase in smartphone capabilities has expanded the potential of these technologies by facilitating the integration of features specific to cell phones with advanced capabilities that extend the reach of what type of information can be assessed and which services can be provided. A recent review of the literature covering the use of ICTs in managing chronic diseases, including addiction, has examined the effectiveness of ICTs, with an emphasis on technologies tested in randomized controlled trials. One example of an addiction-relapse prevention system currently being tested is the Alcohol Comprehensive Health Enhancement Support System (A-CHESS) Program.

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          Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation.

          A McLellan, D. Lewis, C P O'Brien … (2000)
          The effects of drug dependence on social systems has helped shape the generally held view that drug dependence is primarily a social problem, not a health problem. In turn, medical approaches to prevention and treatment are lacking. We examined evidence that drug (including alcohol) dependence is a chronic medical illness. A literature review compared the diagnoses, heritability, etiology (genetic and environmental factors), pathophysiology, and response to treatments (adherence and relapse) of drug dependence vs type 2 diabetes mellitus, hypertension, and asthma. Genetic heritability, personal choice, and environmental factors are comparably involved in the etiology and course of all of these disorders. Drug dependence produces significant and lasting changes in brain chemistry and function. Effective medications are available for treating nicotine, alcohol, and opiate dependence but not stimulant or marijuana dependence. Medication adherence and relapse rates are similar across these illnesses. Drug dependence generally has been treated as if it were an acute illness. Review results suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits. Drug dependence should be insured, treated, and evaluated like other chronic illnesses. JAMA. 2000;284:1689-1695.
          Article 0 comments Cited 237 times – based on 0 reviews     Review now
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            Interactive Health Communication Applications for people with chronic disease.

            J. Burns, Donna E. Murray, I Nazareth … (2004)
            Interactive Health Communication Applications (IHCAs) are computer-based, usually web-based, information packages for patients that combine health information with at least one of social support, decision support, or behaviour change support. These are innovations in health care and their effects on health are uncertain. To assess the effects of IHCAs for people with chronic disease. We designed a four-part search strategy. First, we searched electronic bibliographic databases for published work; second, we searched the grey literature; and third, we searched for ongoing and recently completed clinical trials in the appropriate databases. Finally, researchers of included studies were contacted, and reference lists from relevant primary and review articles were followed up. As IHCAs require relatively new technology, the search time period commenced at 1990, where possible, and ran until 31 December 2003. Randomised controlled trials (RCTs) of IHCAs for adults and children with chronic disease. One reviewer screened abstracts for relevance. Two reviewers screened all candidate studies to determine eligibility, apply quality criteria, and extract data from included studies. Authors of included RCTs were contacted for missing data. Results of RCTs were pooled using random-effects model with standardised mean differences (SMDs) for continuous outcomes and odds ratios for binary outcomes; heterogeneity was assessed using the I(2 )statistic. We identified 24 RCTs involving 3739 participants which were included in the review.IHCAs had a significant positive effect on knowledge (SMD 0.46; 95% confidence interval (CI) 0.22 to 0.69), social support (SMD 0.35; 95% CI 0.18 to 0.52) and clinical outcomes (SMD 0.18; 95% CI 0.01 to 0.35). Results suggest it is more likely than not that IHCAs have a positive effect on self-efficacy (a person's belief in their capacity to carry out a specific action) (SMD 0.24; 95% CI 0.00 to 0.48). IHCAs had a significant positive effect on continuous behavioural outcomes (SMD 0.20; 95% CI 0.01 to 0.40). Binary behavioural outcomes also showed a positive effect for IHCAs, although this result was not statistically significant (OR 1.66; 95% CI 0.71 to 3.87). It was not possible to determine the effects of IHCAs on emotional or economic outcomes. IHCAs appear to have largely positive effects on users, in that users tend to become more knowledgeable, feel better socially supported, and may have improved behavioural and clinical outcomes compared to non-users. There is a need for more high quality studies with large sample sizes to confirm these preliminary findings, to determine the best type and best way to deliver IHCAs, and to establish how IHCAs have their effects for different groups of people with chronic illness.
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              Internet-based chronic disease self-management: a randomized trial.

              Kate Lorig, Philip L Ritter, Diana D. Laurent … (2006)
              The small-group Chronic Disease Self-Management Program (CDSMP) has proven effective in changing health-related behaviors and improving health statuses. An Internet-based CDSMP was developed to reach additional chronic-disease patients. We sought to determine the efficacy of the Internet-based CDSMP. We compared randomized intervention participants with usual-care controls at 1 year. We compared intervention participants with the small-group CDSMP at 1 year. Nine-hundred fifty-eight patients with chronic diseases (heart, lung, or type 2 diabetes) and Internet and e-mail access were randomized to intervention (457) or usual care control (501). Measures included 7 health status variables (pain, shortness of breath, fatigue, illness intrusiveness, health distress, disability, and self-reported global health), 4 health behaviors (aerobic exercise, stretching and strengthening exercise, practice of stress management, and communication with physicians), 3 utilization variables (physician visits, emergency room visits, and nights in hospital), and self-efficacy. At 1 year, the intervention group had significant improvements in health statuses compared with usual care control patients. The intervention group had similar results to the small-group CDSMP participants. Change in self-efficacy at 6 months was found to be associated with better health status outcomes at 1 year. The Internet-based CDSMP proved effective in improving health statutes by 1 year and is a viable alternative to the small-group Chronic Disease Self Management Program.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Alcohol Res Health
                Journal ID (iso-abbrev): Alcohol Res Health
                Journal ID (publisher-id): ARH
                Title: Alcohol Research & Health
                Publisher: National Institute on Alcohol Abuse and Alcoholism
                ISSN (Print): 1535-7414
                ISSN (Electronic): 1930-0573
                Publication date (Print): 2011
                Volume: 33
                Issue: 4
                Pages: 327-337
                Author notes

                D avid H. G ustafson, P h.D., is the director of the Center for Health Enhancement Systems Studies and NIATx (formerly known as the Network for the Improvement of Addiction Treatment) at the University of Wisconsin–Madison, Madison, Wisconsin.

                M ichael G. B oyle, M.A., is chief innovation officer with Fayette Companies in Peoria, Illinois.

                B ret R. S haw, P h.D., is an assistant professor in the Department of Life Sciences Communication at the University of Wisconsin–Madison, Madison, Wisconsin.

                A ndrew I sham, M.S., is a researcher; FIONA MCTAVISH, M.S., is deputy director; S tephanie R ichards, is an outreach specialist; and C hristopher S chubert, is a project assistant, all at the Center for Health Enhancement Systems Studies at the University of Wisconsin–Madison, Madison, Wisconsin.

                M ichael L evy, P h.D., is director of clinical treatment services at CAB Health & Recovery Services in Peabody, Massachusetts.

                K im J ohnson, M.S., is deputy director of NIATx at the University of Wisconsin–Madison, Madison, Wisconsin.

                Article
                Publisher ID: arh-33-4-327
                PMC ID: 3536059
                PubMed ID: 23293549
                SO-VID: 3c53a338-169f-4ec5-916d-e347c71c1603
                Copyright statement: Copyright @ 2011
                License:

                Unless otherwise noted in the text, all material appearing in this journal is in the public domain and may be reproduced without permission. Citation of the source is appreciated.

                History
                Categories
                Subject: Focus On: E-Health Solutions

                Keywords: alcohol use disorders (auds),treatment method,self-management,continuing care,information and communication technologies (icts),alcohol comprehensive health enhancement support system (a-chess) program,telecommunication technology,smartphone,literature review
                Data availability:
                Keywords: alcohol use disorders (auds), treatment method, self-management, continuing care, information and communication technologies (icts), alcohol comprehensive health enhancement support system (a-chess) program, telecommunication technology, smartphone, literature review

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