MyWayUp: A Digital Intervention for Alcohol Use Disorder in Patients With Alcohol-Related Liver Disease—Results From an RCT

Abstract

Background: Alcohol-related liver disease (ArLD) is a public health concern that requires multidisciplinary interventions. Digital health tools may improve retention in alcohol use disorder (AUD) treatment and enhance health outcomes. This study explores a blended intervention (brief intervention plus a serious game (SG) based on motivational interviewing and cognitive-behavioural therapy) on AUD in patients with ArLD. Methods: Randomised, single-blinded controlled trial on patients with recent-onset ArLD and AUD. Brief intervention plus the SG was compared to standard addiction therapy. Primary outcomes were AUD treatment retention and adherence at 6 months. Secondary outcomes included liver disease progression, alcohol use patterns, quality of life, functionality, motivational changes and usability. Results: Seventy-nine patients (mean age 56, MELD-Na 14) were included. Participants in the intervention arm were three times more likely to remain in treatment at month six than those in the control arm (adjusted odds ratio (aOR) 3.24; 82.9% vs. 47.4% of engagement respectively) and attended 50% more appointments. Effect sizes (Cohen's D) were moderate for adherence at months three and six (0.51–0.64). At 6 months, Model for End-Stage Liver Disease Sodium (MELD-Na) scores were lower in the experimental group (12 vs. 16, p < 0.001). Among baseline drinkers, alcohol consumption decreased more in the intervention group at month one (11 vs. 6 Standard Drink Units (SDU)/day, p = 0.031). Conclusion: The blended intervention increases engagement with AUD treatment, reduces the amount of consumed alcohol and improves MELD-Na scores. These results support the use of digital tailored interventions for AUD in these patients.