Improving Remote Breathalyzer Procedures used by Clinicians and Researchers to Remotely Monitor Alcohol Use

改进临床医生和研究人员用于远程监测酒精使用情况的远程呼吸分析仪程序

• 批准号: 10670837
• 负责人: Donald M Dougherty
• 金额: $ 18.96万
• 依托单位: UNIVERSITY OF NORTH TEXAS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10670837
• 关键词: Abstinence; Adopted; Adoption; Alcohol consumption; Alcohols; Area; Behavior Therapy; Biological Markers; Blood; Blood alcohol level measurement; Blood specimen; Breath Tests; Clinical; Data; Detection; Devices; Disadvantaged; Effectiveness; Event; Excretory function; Face; Failure; Forensic Medicine; Frequencies; Future; Health Technology; Heavy Drinking; Hour; Incentives; Individual; Intervention; Manufacturer; Measurement; Measures; Methods; Monitor; Motivation; National Institute on Alcohol Abuse and Alcoholism; Participant; Pattern; Periodicals; Persons; Physical activity; Procedures; Protocols documentation; Public Health; Recommendation; Reporting; Research; Research Personnel; Sampling; Secure; Skin; Sleep; Specificity; Spottings; Strategic Planning; Testing; Text Messaging; Time; Violence; Waiting Lists; Work; alcohol measurement; alcohol monitoring; breath alcohol measurement; clinical practice; contingency management; cost; drinking; driving under influence; dual diagnosis; eHealth; handheld mobile device; improved; liver transplantation; offender; phosphatidylethanol; recruit; remote monitoring; secondary analysis; social stigma; wearable sensor technology

Project Summary/Abstract The availability of wearable biosensors that continuously and/or remotely monitor alcohol use is increasing and has created new opportunities for research and intervention in clinical practice and forensic settings. Our previous work in this area has focused on transdermal alcohol monitors, which remotely and continuously monitor alcohol excreted through the skin. While such devices, like Secure Continuous Remote Alcohol Monitors, have been validated and found reliable, they have some disadvantages that limit widespread adoption including availability, cost, size, interference with physical activities, and stigma. One alternative is the use of breathalyzers that remotely sample and report breath alcohol levels across the day. These are becoming the preferred method for monitoring alcohol use in settings where continuous monitoring for alcohol consumption is required. Although remote breathalyzers are accurate for detecting current blood alcohol levels and identifying the individual providing the sample through facial recognition, their primary limitation could be the failure to detect drinking when monitoring is absent during the "off- cycle”; the 10 hours between early 9pm and 6am when heavy alcohol use could occur. Individuals who have difficulty remaining abstinent and may adopt a pattern of drinking during “off-cycle” periods to avoid the negative consequences associated with positive breath samples. We propose that current practices for remote alcohol breath monitoring in research, clinical, and judicial settings are inadequate to detect drinking. Specifically, we aim to evaluate the accuracy of remote breath alcohol monitoring to detect drinking events; and determine if drinking undetected by remote breath alcohol monitoring can be identified by phosphatidylethanol measurement. We expect that breath alcohol monitoring (and infrequent blood spot sampling) will be more acceptable than transdermal alcohol monitoring. This work challenges current practices by providing evidence of “off-cycle” drinking (Aim 1) and will improve existing methods by validating remote breath testing plus periodic measures of phosphatidylethanol (Aim 2). We also will determine the optimal frequency of phosphatidylethanol measurements to confidently confirm abstinence or identify those who may be motivated to adopt patterns of drinking to avoid detection and consequences (Aim 2). This work will help redefine remote alcohol-use monitoring procedures and significantly improve clinical, forensic and research practices.

项目概要/摘要 持续和/或远程监测酒精使用情况的可穿戴生物传感器的可用性 增加并为临床实践和法医学的研究和干预创造了新的机会 设置。我们之前在这一领域的工作重点是透皮酒精监测仪，它可以远程和 持续监测通过皮肤排出的酒精。虽然此类设备（例如 Secure Continuous） 远程酒精监测仪已经过验证并被发现可靠，但它们有一些缺点限制 广泛采用，包括可用性、成本、规模、对身体活动的干扰和耻辱。一 另一种方法是使用呼气分析仪，远程采样并报告全天呼气酒精浓度。 这些正在成为在连续的环境中监测酒精使用情况的首选方法 需要监测酒精消耗量。尽管远程呼气分析仪可以准确检测 当前血液酒精浓度并通过面部识别识别提供样本的个人， 它们的主要局限性可能是在“休息期间”缺乏监测时无法检测到饮酒情况。 周期”；晚上 9 点到凌晨 6 点之间的 10 个小时，可能会大量饮酒。 难以保持戒酒，可能会在“非周期”期间采取饮酒模式，以避免 与阳性呼吸样本相关的负面后果。我们建议当前的做法 研究、临床和司法环境中的远程酒精呼吸监测不足以检测饮酒情况。 具体来说，我们的目标是评估远程呼吸酒精监测检测饮酒事件的准确性； 并确定是否可以通过远程呼吸酒精监测来识别未检测到的饮酒行为 磷脂酰乙醇测量。我们预计呼吸酒精监测（以及不常见的血斑 采样）比经皮酒精监测更容易被接受。这项工作挑战了当前 通过提供“非周期”饮酒的证据（目标 1）来改进现有方法 验证远程呼气测试以及定期测量磷脂酰乙醇（目标 2）。我们也会 确定磷脂酰乙醇测量的最佳频率，以自信地确认戒断或 识别那些可能有动机采取饮酒模式以避免被发现和后果的人 （目标 2）。这项工作将有助于重新定义远程酒精使用监测程序并显着改善 临床、法医和研究实践。