Mendelson 2018: Ria Health's poster on its first 230 patients

What they tested

Ria Health runs a telehealth program for alcohol use disorder. Patients see a doctor through a smartphone app, can get medicine to curb drinking (naltrexone and others), and work with a recovery coach. They also blow into a breathalyzer linked to their phone each day.

The poster analyzed evening breath tests over 6 months from 230 patients (16,952 readings), using a statistical model of the trend over time. Patients with no baseline alcohol measurement (26) and those who only did product testing (7) were left out. The poster says Friends Research Institute designed and ran the analysis on de-identified data.

What they found

Both statistical models showed breath alcohol falling over time. Average breath alcohol went from .07 at the start to .03 at 6 months, a 57.1% decrease.

The poster also reports estimated standard drinks falling from 30 to 10 a week and non-drinking days rising from 1.5 to 4.3 a week. Drinks were estimated from breath readings, gender and weight, not counted directly.

As of March 23, 2018, Ria had enrolled 393 patients, and 57% were still enrolled and engaged at the 180-day point. Patients paid a monthly subscription fee of $99-249.

Limits

• There was no comparison group, so the poster can't show the program caused the drop in drinking.
• It is a company poster, not a peer-reviewed paper, and the lead author is from Ria Health.
• Only 57% of enrolled patients were still in the program at 180 days, so the later readings come mostly from people who stayed.
• The poster's figures don't fully match: weekly drinks at the start are given as 37 in one section and 30 in another.

What it means if you're considering naltrexone

The poster shows that people who stayed in Ria's app-based program, which can include naltrexone, drank less over 6 months by breathalyzer. It can't show how much of that came from the medicine, the coaching or other factors, and it was produced by the company that sells the program.