Use of transdermal alcohol sensors in conjunction with contingency management to reduce alcohol consumption in people with alcohol dependence attending alcohol treatment services: Feasibility randomised controlled trial

Abstract

Abstract Background Wearable technology for objective, continuous and reliable alcohol monitoring has been developed. These devices are known as transdermal alcohol sensors (TAS). They can be worn on the wrist or ankle with the sensor pressed against the skin and can measure sweat vapours being emitted from the skin, to record transdermal alcohol concentration (TAC). Previous studies have investigated the accuracy and acceptability of the available TAS brands but there has been little research into their use in people with alcohol use disorders (AUD). This pilot RCT aims to explore the feasibility, strengths, and limitations of using a TAS to monitor alcohol consumption in individuals in treatment for AUD with or without contingency management (CM) to promote abstinence or low-level alcohol consumption. Method Both groups (control and CM) will wear the TAS (BACtrack Skyn) for two weeks in the context of their usual treatment, meeting with the researcher every other weekday. In the last meeting the participants will complete a post-wear survey on their experience of wearing the TAS. The CM group will also receive small financial incentives for low or no alcohol consumption, as measured by the TAC. On days where the TAC peak is below a set threshold, CM group participants will earn £5. There are financial bonuses if this target is achieved on consecutive days. The researcher will monitor TAC for each day of the study at each research visit and allocate financial incentives to participants according to a set reinforcement schedule. Discussion Most TAS brands have had limited application in clinical settings and most studies have included healthy adults rather than people with AUD. TAS has the potential to enhance treatment outcomes in clinical alcohol treatment. The accuracy, acceptability, and feasibility of TAS in people with AUD in clinical settings needs to be investigated. This is the first study to use TAS in specialised alcohol services with diagnosed AUD individuals currently receiving treatment from a south London alcohol service. Trial registration: ISRCTN registration number. Retrospectively registered. Date of registration: 24.07.23