# Combining a Smartphone App with Medications to Manage Heavy Drinking

> **NIH VA I01** · VA PUGET SOUND HEALTHCARE SYSTEM · 2024 · —

## Abstract

Background: Alcohol use disorder (AUD) affects 1 in 10 Veterans and is associated with significant morbidity
and mortality. However, few individuals receive evidenced-based psychosocial interventions or medications for
AUD (MAUD). Common barriers to treatment include long wait times, stigma, and distance from treatment
facilities. Despite clinical guidelines and evidence indicating superior outcomes, even fewer individuals receive
MAUD and psychosocial interventions conjointly. The VA prioritizes expanding access to AUD interventions in
primary care, but it is difficult to deliver psychosocial interventions in primary care, and care often includes
MAUD only. Smartphone mobile applications (apps) that deliver psychosocial interventions concurrent with
MAUD may address the gap between recommended and current practices for AUD and appeal to Veterans
who prefer to receive their AUD care in primary care. Alcohol intervention apps have been associated with
improved drinking-related and mental health outcomes. Self-monitoring of alcohol use, a common feature in
apps, may also increase MAUD adherence. Step Away, an app for self-management of alcohol use problems,
is designed to guide development and use of personalized strategies to moderate or abstain from drinking. In
single-arm cohort studies, we assessed the acceptability and usability of Step Away and Stand Down (SD-
App), the Veteran version of the app and focus of this proposal, among Veterans with alcohol use problems.
The apps received favorable ratings regarding perceived effectiveness, efficiency, and overall satisfaction, and
were associated with reductions in heavy drinking days and drinking-related consequences.
Significance: This study has the potential to substantially improve Veterans’ receipt of guideline-concordant
AUD care and support national VA initiatives to increase access to AUD care in general healthcare clinics.
Innovation & Impact: To our knowledge, no prior study has evaluated the effectiveness of an alcohol-related
intervention, delivered by smartphone, with MAUD in primary care. Smartphone apps can be scaled up at
relatively low cost, potentially saving lives and improving the quality of care of tens of thousands of Veterans.
Specific Aims: Our two aims are to: 1) determine whether MAUD plus SD-App offered to primary care
patients diagnosed with AUD, compared to MAUD only, results in (a) greater reductions in heavy drinking
days, from baseline to 6-months (primary), (b) greater improvements in alcohol consequences, alcohol use risk
levels, and mental health outcomes, from baseline to 6-months (secondary), 2) conduct a process evaluation
to identify factors that influence the adoption, implementation, and sustainability of SD-App in combination with
MAUD in VA primary care from Veterans’, clinical pharmacist specialists’ and clinical leaders’ perspectives. We
will also explore whether MAUD plus SD-App increases MAUD 6-month adherence relative to SD-App alone.
Methodology: Gu...

## Key facts

- **NIH application ID:** 10753109
- **Project number:** 1I01HX003742-01A1
- **Recipient organization:** VA PUGET SOUND HEALTHCARE SYSTEM
- **Principal Investigator:** Eric Hawkins
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-04-01 → 2028-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10753109

## Citation

> US National Institutes of Health, RePORTER application 10753109, Combining a Smartphone App with Medications to Manage Heavy Drinking (1I01HX003742-01A1). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10753109. Licensed CC0.

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