Alcohol places a significant burden on the National Health Service (NHS); yet, uptake of cost-effective approaches remains low. Digital interventions may overcome some barriers to delivery. The Drink Less app has evidence of being effective at supporting heavier drinkers to reduce their alcohol intake. In this study, we estimate the longer-term health impacts, cost-effectiveness, and health inequality impact of a large-scale rollout of the Drink Less app.
We used the Sheffield Alcohol Policy Model to estimate changes in alcohol consumption, hospital admissions, mortality, and NHS costs of 2 rollout scenarios over a 20-year time horizon: (1) a mass media awareness campaign and (2) a targeted drive to embed referral to Drink Less within primary care. We modeled the cost-effectiveness and inequality impact of each approach in a distributional cost-effectiveness analysis.
A mass media campaign is estimated to reduce per capita alcohol consumption by 0.07 units/week and avert 108 556 hospital admissions and 2606 deaths over 20 years, gaining 24 787 quality-adjusted life-years at a net saving to the NHS of £417 million. Embedding in primary care is estimated to reduce consumption by 0.13 units/week, saving 188 452 admissions and 4599 deaths and gaining 38 897 quality-adjusted life-years at a net saving of £590 million. Both scenarios are estimated to reduce health inequalities, with a larger reduction for the primary care approach.
A large-scale rollout of the Drink Less app is estimated to be health improving, cost saving, and reducing health inequalities. Embedding the use of Drink Less within primary care is likely to be the more effective approach.
The research on the Drink Less app is significant because it addresses the serious health issues caused by alcohol consumption, which leads to many deaths and health complications in England. The study examines how a large-scale rollout of the app could improve health, save costs for the National Health Service (NHS), and reduce health inequalities.
Using the Sheffield Alcohol Policy Model, two strategies for implementing the Drink Less app were analyzed over a 20-year period: (1) a mass media campaign to raise awareness and (2) embedding the app's promotion within primary care settings. The results indicated that both strategies could lead to reduced alcohol consumption, fewer hospital admissions, and lower mortality rates. The mass media campaign is expected to decrease weekly alcohol consumption by about 0.07 units, preventing over 108,000 hospital admissions and around 2600 deaths, resulting in savings of £417 million for the NHS. On the other hand, embedding the app into primary care is projected to reduce consumption by 0.13 units per week, saving nearly 188,000 hospital admissions and 4600 lives, with an estimated NHS savings of £590 million.
Importantly, both strategies can improve health equity, but the embedding approach is likely to bring even greater benefits, particularly for disadvantaged populations. The study emphasizes that a large-scale rollout of the Drink Less app can lead to better health outcomes while also being cost-effective and addressing health inequalities. This highlights the potential for digital tools in public health strategies, especially when integrated into primary care practices, and the necessity for increased awareness and recommendations from healthcare providers to enhance app usage.
In conclusion, the Drink Less app presents a promising opportunity to tackle alcohol-related health issues in England effectively, with the potential for significant savings and improvements in health equity. Researchers, healthcare decision makers, and patients should consider these findings when discussing strategies to reduce alcohol consumption and its associated harms.