Mitchell 2020: drinking changes in Ria Health's telehealth program

What they tested

The Ria Treatment Platform is a telemedicine program run through a smartphone app. It bundles physician visits, with prescriptions for alcohol use disorder medicines when appropriate, text and phone support from a recovery coach, video monitoring of whether people take their medicine, and a Bluetooth breathalyzer that records alcohol intake.

The researchers analyzed daily breathalyzer readings of blood alcohol content from 77 adult patients over their first 90 days, using a statistical method called dynamic structural equation modeling.

What they found

55% of patients were still in treatment at 90 days, so nearly half had left.

Among patients who stayed engaged for the full 90 days, average blood alcohol readings fell approximately 50%, from .091 at the start to .045 at day 90.

The abstract doesn't report how many patients took naltrexone or any other medicine, so the results can't be tied to a specific drug.

Limits

• There was no comparison group and no random assignment. The authors say studies with both are needed to judge the program.
• The 50% drop describes only people who stayed engaged for 90 days, not everyone who started.
• The data come from Ria's own patients, and Ria's chief medical officer is one of the authors.

What it means if you're considering naltrexone

Ria's peer-reviewed evidence is this one observational study. It suggests drinking fell among people who stuck with the program, but it can't separate the effect of medicines such as naltrexone from coaching, breathalyzer monitoring, or the kind of people who stay in treatment.