JMIR Publications

ABSTRACT

Background:

Alcohol use disorder (AUD) is associated with cognitive impairments that are known to impede on the outcomes of conventional treatment. Digital cognitive training programs have been examined as a possible way of addressing these overlooked challenges. Existing findings regarding the efficacy of such training programs are divergent, and further studies are warranted to examine more engaging cognitive training programs using the latest technology. Smartphone-based training built upon the principles of serious gaming would not only increase the accessibility of the program, but it could also increase the motivation of the patients – potentially maximizing adherence to the training program.

Objective:

The aim of the present feasibility and efficacy study was to examine the feasibility and acceptability of the Brain+ Alco-Recover application with gamified elements among patients with AUD when delivered as add-on to treatment-as-usual (TAU) and with minimal guidance from health-care practitioners. Additionally, the effects on cognitive and alcohol-related outcomes were examined.

Methods:

A total of 72 outpatients were randomized into either: Group A) experimental + TAU (n = 36), or Group B) sham + TAU (n = 36), and they had to complete a 1-month training program in addition to primary treatment. Self-reported experience at six months follow-up as well as actual game usage was used to determine the feasibility of the training program. Cognitive performance and alcohol consumption were assessed as well.

Results:

The patients in both groups reported a high level of acceptability, and up to 83% of the patients in the experimental group met the minimum requirements for the usage of the application. The experimental group also demonstrated significant improvements in working memory (P < .001). Although no significant differences were found between the two groups regarding clinical outcomes, a greater reduction in alcohol consumption was evident at 6-months follow-up in the experimental group.

Conclusions:

The acceptability and adherence to the minimum training requirements deems the gamified, Brain+ application as a feasible tool for cognitive training when delivered as add-on to TAU. Furthermore, the potential improvements in cognitive functions should be further replicated in a larger scaled trial to assess whether these could be used to improve the treatment of AUD in the future. Clinical Trial: A pre-registered and published research protocol is available (IRRID: RR2-10.3389/fpsyt.2021.727001)