Associate professor examines telemedicine as tool for alcohol use disorder management

Telemedicine continues to gain traction as an avenue to combat a disorder that kills an estimated 88,000 people annually in the U.S.

According to the Centers for Disease Control and Prevention, that is the annual death toll in the U.S. from excessive alcohol use. Dr. Scott Kruse, an associate professor in Texas State University’s School of Health Administration, headed a systematic review of the effect of telemedicine in the management of alcohol abuse. The findings were recently published in The Journal of Medical Internet Research.

“My primary area of research is the adoption of health information technology to improve medical outcomes,” Kruse said. “So telemedicine comes to the forefront quite often. Once a year, I teach an advanced course in our Master of Healthcare Administration program. I teach the students how to conduct a systematic review. I posit several areas of research I have already started and offer to let them help on initial research. This was one of those efforts with several grad students in our course.”

Alcohol use disorder is defined as a chronic brain disease in which a person displays compulsive alcohol use, loss of control in regard to alcohol intake and a negative emotional state when not using. Telemedicine allows technology to eliminate proximity from the point of care. “We have seen several advancements in telemedicine,” Kruse said. “An app can signal to a person that he or she is approaching an area of temptation. Apps can also help them monitor location and amount of alcohol intake.”

Information can be processed by people on a real-time basis as opposed to verbal communication with a family member or group sponsor, which might include a missed phone call or a trip for face-to-face discussion. Kruse found that the use of telemedicine to treat alcohol dependence increases a patient’s access to multiple providers and support outside the clinical environment. “Telemedicine becomes a force multiplier for providers,” Kruse said. “A lot of patients feel like there are advantages to getting treatment through telemedicine. There is a stigma for patients being seen walking into a clinic that manages alcohol use disorder. That can be avoided through telemedicine.”

In addition to the annual death toll, alcohol use disorder affects 18 million Americans through lost work hours, a decline in quality of life and a decrease in life expectancy. The CDC notes that 2.5 million years of potential life were lost were lost annually in the U.S. from 2006-10. To examine the effectiveness of telemedicine in addressing the far-reaching effects of alcohol use disorder, the review authors divided 94 abstracts to be screened among five authors. They read 29 articles before selecting a total of 22 articles for group analysis.

Dr. Kim Lee, an assistant professor in the School of Health Administration, examined the strategic management implications for healthcare administrators. 

“There is not a whole lot of infrastructure involved,” Kruse said. “It’s more technique. The innovation is not technologically based in terms of huge amount of cost. She focused on how can the healthcare administrator capitalize on telemedicine – specifically in the area of treating alcohol use disorder and addiction in their facilities and use that force multiplier to increase access for the organization?”

Through systematic analysis of current literature, reviewers measured effectiveness, efficiency and quality of use of telemedicine in managing alcohol abuse, addiction and rehabilitation in patients. Efficiency was measured through cost. Quality was measured in terms of safety, timeliness, access, patient satisfaction or quality of life.

The power of apps to efficiently give patients access to resources struck a chord with Kruse. “The real time aspect – having a real-time coach was a real eye-opener for me when I went through the research,” Kruse said. “The applications rank high on ease of use. They are not battery hogs for phones and the GPS of the phone allows users to highlight where their weak spots are. So it helps them manage areas where they feel they can improve and need to improve. It is there to remind them.”

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