JMIR Publications

ABSTRACT

Background:

Screening and intervention for alcohol use disorders (AUD) are recommended to improve alcohol-related liver disease (ALD) patient prognosis. Most patients’ smartphone application (app) diaries record drinking behavior for self-monitoring, but such data might be useful by treating teams.

Objective:

Aims of this study were to assess the use of a smartphone-app as a recording diary and to evaluate the usability of this tool for ALD patients.

Methods:

This pilot study used a newly developed smartphone journaling app for patients, with input data that physicians can review. After ALD patients were screened for harmful alcohol use, some were invited to use the smartphone journaling app for 8 weeks. Their self-reported alcohol intake, symptoms, and laboratory data were recorded at entry, week 4, and week 8. Later, their recorded data were reviewed by outpatient clinic physicians to evaluate changes in alcohol consumption, laboratory data, and app usage.

Results:

Of 14 patients agreeing to participate, 10 completed 8-week follow-up with diary input rates between 44% and 100% of expected days. Two withdrew from clinical follow-up. Two others never used the smartphone journaling app. Using the doctor’s view, a treating physician gave feedback comments to patients at each visit. Self-reported alcohol consumption dropped from baseline (100 ±70 g) to week 4 (13±25 g, p<0.01) and remained lower to week 8 (13±23 g). Five patients reported complete abstinence during the study. During the study period, decreases in total bilirubin (3.0±2.4 to 2.4±1.9 mg/dL, p=0.01) and increases in serum albumin (3.0±0.9 to 3.3±0.8 g/dL, p<0.01) were recorded.

Conclusions:

These pilot study findings revealed that the smartphone journaling app used by both patients and treating physicians produced short-term reduced drinking and enhanced patient motivation.