Alcohol Use the Sole Focus of Comprehensive Telehealth Program

A telehealth platform geared solely to individuals with an alcohol use disorder is proving a convenient fit for several at-risk groups, especially women for whom work and family demands make attending an in-person treatment program unlikely.

Ria Health, a program established in 2016, is accessed through a smartphone app and combines physician and recovery coach support with video monitoring of medication adherence and Bluetooth-linked Breathalyzer tracking. Leaders of the initiative believe it is an ideal match for populations such as women and older adults—groups that are seeing an increased prevalence of alcohol use disorders.

“We didn't start out focusing on women,” Ria Health CEO Tom Nix tells Addiction Professional. “The things we were hearing from them were that for people who are employed and with significant responsibilities for child care, telehealth resonates for them.”

The organization has begun to report data suggesting that the telehealth program is keeping people engaged in treatment longer and using medication treatments for alcohol use disorder more frequently. In a poster presentation last spring at the annual conference of the American Society of Addiction Medicine (ASAM), Ria Health reported that just over half of the 501 patients it had workled with in the period through early September 2018 had remained enrolled in the program at 180 days.

In addition, a study published online this month in The American Journal of Alcohol and Drug Abuse found that among a group of 77 Ria Health patients, those who remained engaged in the treatment protocol for 90 days saw their average blood alcohol levels drop by around 50% from baseline to day 90. Ria Health co-founder and chief medical officer John Mendelson was a co-author of that study.

Flexible approach

Mendelson tells Addiction Professional that alcohol use disorder became the focus of this program in large part because “there is so little adherence to any evidence-based guidelines in its treatment.”

He says there is too much of a tendency in the treatment industry to expect dramatic change from patients almost immediately. He and Nix explain that the Ria Health program takes a flexible approach toward a patient's goals.

“For many, the concept of stopping or quitting forever is difficult to put one's arms around,” Nix says. Some patients want to reduce their drinking and move toward abstinence, he says, while others may see themselves restricting future drinking to one day per week.

After a first visit in which a comprehensive assessment is completed, a patient typically will have a second visit within a few days to be initiated to medication. Mendelson says if the patient is already abstinent from alcohol use, acamprosate may be used. If someone is coming in with a controlled drinking mindset, the medication of choice may be naltrexone, gabapentin, baclofen or topiramate, he says.

Patients receive text- and phone-based support from a recovery coach over the course of their treatment. In the first few months of the program, they are likely to have weekly check-ins with the coach and a couple of monthly visits with the physician and nurse practitioner team. Nix says the average stay in treatment has been just over 10 months.

Company leaders have announced that in half of the 14 states where Anthem manages health services, Ria Health will serve as a specialty telehealth provider and the services will be covered by the insurer. They add that other insurance contracts are being negotiated as well.

“This platform is very scalable,” Nix says. “Our goal is to reach all of the adults in the U.S.”

He adds, “Our singular focus on one condition as a center of excellence, we know it is in the best interest of our patients to be experts in one area.”