# Testing an mHealth System for Integrating Alcohol Use Treatment with Hepatology Care for Patients with Alcohol-associated Liver Disease

> **NIH NIH R01** · UNIVERSITY OF WISCONSIN-MADISON · 2024 · $617,700

## Abstract

Alcohol-associated liver disease (ALD) rates have risen markedly over the past 15 years, becoming the most
common indication for liver transplantation in the U.S. and generating the majority of healthcare and cost
burden among all liver diseases. With the COVID pandemic, these trends have worsened, and it is estimated
that, if nothing is done to stem the tide, ALD-related mortality will double by 2040. Despite decades of medical
research, alcohol cessation remains the only intervention that substantially decreases long-term ALD morbidity
and mortality. However, only 10-15% of ALD patients access alcohol use treatment in the first year after their
diagnosis, with women even less likely to access treatment compared to men. Despite these gaps, surprisingly
few behavioral interventions for alcohol cessation have been tested in ALD patients, and, of those that have
been tested, integrated alcohol cessation treatment alongside medical and hepatology care has had the most
impact at reducing alcohol use. To address these critical research gaps, the investigators will perform a
randomized, controlled, Type 1 hybrid implementation-effectiveness trial in a population of ALD patients to
evaluate the effectiveness of CHESS Health Connections (a smartphone app for alcohol cessation shown to
significantly reduce risky drinking in a prior randomized clinical trial of patients with severe alcohol use
disorder). Patients will be enrolled in both general hepatology and multidisciplinary ALD clinics (which include
integrated alcohol use treatment professionals alongside hepatology providers) at two large tertiary care
centers (University of Wisconsin and University of Michigan). Aim 1 will compare the effectiveness of CHESS
plus usual care (n=180) versus usual care (n=181) on days of abstinence over 6 months. Aim 2 will assess
implementation of CHESS through qualitative interviews of key patient, provider, and clinic-level stakeholders
using the Replicating Effective Programs framework and implementation costs. Our secondary/exploratory
analyses will examine intervention effects on health outcomes including depression, anxiety, insomnia, AUD
treatment engagement, and liver health. We will examine key moderators (age, sex, rurality, presence of
formal AUD treatment, and stage of ALD) and mediators (relatedness, competence, autonomous motivation)
on outcomes. We will also examine the impact of the CHESS app on measures of chronic liver impairment
using the Model for End-Stage Liver Disease-Sodium score. This study will build on over a decade of work in
adapting and using CHESS in various populations with alcohol use disorder. This study is highly innovative in
three ways: 1) it is the first fully powered effectiveness trial of a proven smartphone app for alcohol cessation in
ALD patients, 2) it will test a new model of care for delivering alcohol cessation treatment to ALD patients, and
3) it will utilize a novel collaboration of systems engineering and medical resear...

## Key facts

- **NIH application ID:** 10932395
- **Project number:** 5R01AA030470-02
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** Randall T Brown
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $617,700
- **Award type:** 5
- **Project period:** 2023-09-20 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10932395

## Citation

> US National Institutes of Health, RePORTER application 10932395, Testing an mHealth System for Integrating Alcohol Use Treatment with Hepatology Care for Patients with Alcohol-associated Liver Disease (5R01AA030470-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10932395. Licensed CC0.

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