ALCOHOL RELAPSE PREVENTION VIA PROSPECTIVE IVR FOLLOW-UP

提出了一种创新的交互式语音应答（IVR）系统，将计算机化的饮酒自我监测和自动化的认知-行为应对技能培训与酒精中毒治疗后出院的后续护理相结合。饮酒和饮酒相关冲动的个人日记被广泛提倡用于激励和鼓励减少酒精消费，并且已经开发了用于需求评估和治疗的计算机自动化电话外展计划，并且在卫生保健的其他领域中显示出有效和成本效益。日常饮酒的IVR监测已被确定为一项重要的新技术，需要进一步完善和发展，作为研究和临床工具（Sobell & Sobell，1995）。IVR数据收集程序和患者反馈机制（鼓励成功，防止“失误”开始完全复发）可以促进和建立在治疗成功的基础上。积极主动的支助机制，例如由顾问发起的后续行动，可以最大限度地减少本来不会被发现的问题的影响。本研究将评估这些技术，以减少出院后复发和检测复发后发病，从而促进更直接，更少的强度，更有效的干预。相对于再治疗的经常性成本，一个表现出疗效和成本效益的复发预防计划对保险公司和治疗提供者都有吸引力。 IVR技术提供了一个机会，以一种具有成本效益的方式与正在康复的酗酒者进行长期、频繁的互动，这种方式可以在预防上花几分钱，而在随后进行更密集、更低效的干预上花几美元。建议的商业应用：每年有数十亿美元用于治疗酗酒和与酒精有关的问题。这项建议的基本思想是，给予康复中的酗酒者免费使用交互式语音反应监测，可以有效地帮助他们建立和维持具有成本效益的治疗目标，使购买这种服务对治疗提供者具有吸引力。IVR技术提供了一个机会，以一种具有成本效益的方式为康复中的酗酒者提供长期、个性化、频繁的接触，这种方式可以在预防上花费的几分钱与随后更密集的干预上节省的美元之间进行权衡。

An innovative interactive voice response (IVR) system is proposed, integrating computerized self-monitoring of drinking and automated cognitive-behavorial coping skills training with follow-up aftercare of patients discharged from alcoholism treatment. Personal diaries of drinking and drinking-related urges are widely advocated for motivating and encouraging the reduction of alcohol consumption, and computer- automated telephone outreach programs for needs assessment and treatment have been developed and shown effective and cost efficient in other areas of health care. IVR monitoring of daily drinking has been identified as an important new technique needing further refinement and development as both a research and clinical tool (Sobell & Sobell, 1995). IVR data collection procedures and patient feedback mechanisms (encouragement of success, prevention of "slips" from initiating complete relapse) can promote and build upon treatment success. Proactive support mechanisms, such as counselor-initiated follow-up, can minimize the impact of problems that would not otherwise be detected. This research will evaluate these techniques for reducing relapse following discharge and for detecting relapse following onset, thereby facilitating more immediate, less intensive, and more effective intervention. A relapse prevention program demonstrating efficacy and cost efficiency, relative to the recurrent costs of retreatment, would be attractive to both insurers and treatment providers. IVR technology offers the opportunity for long-term, frequent interaction with recovering alcoholics in a cost-efficient fashion that could trade-off pennies for prevention against dollars for more intensive, less effective intervention subsequently. PROPOSED COMMERCIAL APPLICATIONS: Billions of dollars are spent annually treating alcoholism and alcohol- related problems. The basic idea of this proposal is that recovering alcoholics given toll-free access to interactive voice response monitoring could effectively be assisted in establishing and maintaining treatment goals with cost-efficiencies that would make the purchase of this service attractive to treatment providers. IVR technology offers the opportunity to provide long-term, individualized, frequent contacts with recovering alcoholics in a cost-efficient fashion that could trade-off pennies spent on prevention against dollars saved on subsequent, more intensive intervention.