Alcohol relapse prevention programme NHS Bolton

The Community Alcohol Team at NHS Bolton had identified a lack of client engagement with its aftercare programme, with only 60-70% of clients who had been through detoxification attending aftercare meetings. To address this problem, the project team designed a relapse prevention programme which aimed to:

• increase engagement and retention from 43% to 75%
• reduce re-referral rates by 4%
• reduce costs to health care services by lowering the number of re-referrals for detoxification.

The programme used mobile phone technology to maintain communication with clients and bridge the gap between formal appointments, when the risk of relapse is highest. It incorporated:

1. text message reminders for aftercare appointments
2. daily 'mood monitoring' texts with three answer options - ‘1’ (green), ‘2’ (amber), or ‘3’ (red) - and follow up depending on the response given
3. an easy way for clients to contact the service for support and advice in the event of a relapse or an emergency situation.

Who was involved

The project was delivered by Greater Manchester West Mental Health Trust, addiction charity ADS, the local primary care trust and digital technology company d2 Digital by Design.

Outcomes

• Clients using the mobile phone service had a 72% engagement rate compared to 57% for a control group receiving standard aftercare.
• 69% of clients using the mobile phone service were discharged from aftercare having completed their treatment, compared with 41% of the control group.
• Short term re-referral rates showed significant improvement, with four times fewer re-referrals for the project group. This could amount to savings of over £100,000 a year.