JMIR Publications

ABSTRACT

Background:

Alcohol use disorder (AUD) is associated with cognitive impairments that are known to increase the risk of relapse and impede on the outcomes of conventional treatment. Digital cognitive training programs have been examined as a possible way of addressing these overlooked challenges. However, existing findings regarding the effectiveness of such training programs are divergent, and further studies are warranted to examine more engaging cognitive training programs using the latest technology. Furthermore, the clinical implementation of the training programs must be investigated to ensure the best and most effective treatment for patients with AUD. Using 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 and compliance of the patients – potentially maximizing adherence to the training program.

Objective:

The aim of the present pilot and feasibility study was to examine whether a smartphone application with gamified elements can improve cognitive and alcohol-related outcomes among patients with AUD when delivered as add-on to treatment-as-usual (TAU) and with minimal guidance from health-care practitioners. An adapted version of the Brain+ application was tested, and the feasibility and acceptability were assessed.

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. Cognitive functions and alcohol consumption were assessed at baseline, post-treatment, and at six months follow-up.

Results:

The experimental group demonstrated significant improvements in processing speed and attention (P = .019) as well as working memory (P < .001). Although no significant differences were found between the two groups regarding clinical outcomes, a pattern favoring the experimental group was evident regarding the mean change reduction in alcohol consumption between the assessment at baseline and 6-months follow-up. The Brain+ application was feasible and accepted by both groups, and the experimental group adhered to the minimum training requirements.

Conclusions:

The smartphone-based, serious gaming application showed promising effects for improving cognitive functions when delivered as add-on to TAU, but a larger scaled trial should be conducted in the future to assess its potential clinical effectiveness. Clinical Trial: A pre-registered and published research protocol is available (IRRID: RR2-10.3389/fpsyt.2021.727001)