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The use of technology in enabling people to self-manage their own care is a growth area in health management, and substance misuse is no exception. 

Here, we explore some of the latest research into the use of mobile applications in assisting people to manage their own alcohol intake and the potential impact on substance misuse as a profession.

Hundreds of mobile apps to address alcohol intake

We’re no stranger to digital technology here at Sanctuary Personnel, but we were genuinely quite shocked to learn that there are 662 unique apps classified as ‘reduction’, ‘entertainment’ and ‘blood alcohol content management’ in iTunes and Google Play Stores. This was reported in a paper by David Crane MSc; the first research study exploring the use of Behaviour Control Therapies (BCTs) in alcohol apps. Entitled ‘Behaviour Change Techniques in Popular Alcohol Reduction Apps’, the study was published in the May 2015 edition of the Journal of Medical Internet Research; just a month after The Health Foundation announced its funding for the AlcoChange app.  

In his opening paragraph, David Crane states ‘mobile phone apps have the potential to reduce excessive alcohol consumption cost-effectively’, yet there are several factors that show the current apps available are limited in their application of control theory. 

Behavioural Control Therapies in alcohol apps

Interestingly, in the research paper, those apps classified as alcohol reduction, all free apps and the top 10 paid apps were coded for BCTs. 51 free alcohol reduction apps and the top 10 paid apps contained a mean of 3.6 BCTs. Those BCTs most frequently used were to ‘facilitate self-recording’ (54%) and to ‘provide information on consequences of excessive alcohol use and drinking cessation’ (43%). 

We must remember though, and it is something the author himself refers to, control theory is very much centred on feedback and goal setting in partnership with substance misuse professionals. In reality, changing a person’s behaviour and relationship with alcohol is complex. Their treatment most often involves a number of BCTs, which are tailored to the individual. 

More importantly, most of the apps in the study set a user’s behavioural goal as drinking below daily or weekly guidelines. For somebody seriously needing to address their alcohol intake, these would be ineffectual. Furthermore, one person’s definition of ‘excessive’ could be completely different to another. 

It’s also clear from the research that those looking for apps as a source of information or advice on alcohol usage, are still very much at the mercy of subliminal marketing messaging to promote alcohol. Of the 662 apps, more than half were classified as being entertainment based and promoted drinking. 

The introduction of more targeted apps

Of course, the study was focused on an instant search for alcohol apps, but what about more targeted applications? On 20th April this year, The Health Foundation earmarked AlcoChange as one of 17 selected projects to be part of its new £1.5m innovation programme. 

Our understanding is that the Royal Free London NHS Foundation Trust will be trialling the use of the app amongst patients with alcoholic liver disease. The project involves the use of a breathalyser with a smartphone app to allow them to self-monitor their alcohol intake, with support from substance recovery workers. 

The breathalyser simply connects to a smartphone through a 3.5mm audio jack and allows for an accurate reading to be recorded on the AlcoChange app. 

Not much has been released on the exact details of the project, but potentially, it could create a much more tangible use of mobile apps in terms of influencing behaviour. For a start, it is a cloud based behavioural platform that has the capability of monitoring a user’s data to create personalised nudge messages to influence their drinking. 

The intention it seems is to provide a more precise picture of a user’s alcohol consumption to facilitate recovery rather than technology being used to replace the personalised care offered by substance misuse workers

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