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一项针对美沙酮维持治疗患者的移动干预措施的可行性、可接受性及初步疗效的混合方法评估。

A mixed-methods evaluation of the feasibility, acceptability, and preliminary efficacy of a mobile intervention for methadone maintenance clients.

作者信息

Guarino Honoria, Acosta Michelle, Marsch Lisa A, Xie Haiyi, Aponte-Melendez Yesenia

机构信息

Center for Technology and Health, National Development and Research Institutes.

Center for Technology and Behavioral Health, Dartmouth Center for Psychiatric Research, Geisel School of Medicine at Dartmouth, Dartmouth College.

出版信息

Psychol Addict Behav. 2016 Feb;30(1):1-11. doi: 10.1037/adb0000128. Epub 2015 Nov 30.

Abstract

Despite the recent explosion of behavioral health interventions delivered on mobile devices, little is known about factors that make such applications practical, engaging and useful to their target audience. This study reports on the feasibility, acceptability and preliminary efficacy of a prototype of a novel, interactive mobile psychosocial intervention to reduce problematic drug use among clients in methadone maintenance treatment (MMT). A mixed-methods pilot study with new MMT clients (n = 25) indicated that the mobile intervention approach was feasible, and that participants found the intervention highly acceptable and useful. On 100-point visual analog scale (VAS) items, participants reported high levels of liking the program (M = 75.6), and endorsed it as useful (M = 77.5), easy to use (M = 80.7), and containing a significant amount of new information (M = 74.8). When compared with 25 study participants who received standard MMT alone, pilot participants rated their treatment significantly higher in interestingness and usefulness, and were significantly more satisfied with their treatment. In qualitative interviews, participants reported using the mobile intervention in a range of settings, including during times of heightened risk for substance use, and finding it helpful in managing drug cravings. Additionally, pilot participants showed evidence of increased treatment retention and abstinence from illicit opioids (in terms of effect size) over a 3-month period relative to those in standard MMT, suggesting the application's potential to enhance treatment outcomes. These promising findings suggest that an evidence-based mobile therapeutic tool addressing substance use may appeal to drug treatment clients and have clinical utility as an adjunct to formal treatment.

摘要

尽管近期通过移动设备提供的行为健康干预措施激增,但对于使此类应用程序对其目标受众切实可行、引人入胜且有用的因素却知之甚少。本研究报告了一种新型交互式移动心理社会干预措施原型在美沙酮维持治疗(MMT)中减少服务对象药物使用问题的可行性、可接受性和初步疗效。一项针对新MMT服务对象(n = 25)的混合方法试点研究表明,移动干预方法是可行的,参与者认为该干预措施非常可接受且有用。在100分的视觉模拟量表(VAS)项目中,参与者报告对该项目的喜爱程度很高(M = 75.6),并认可其有用(M = 77.5)、易于使用(M = 80.7)且包含大量新信息(M = 74.8)。与仅接受标准MMT的25名研究参与者相比,试点参与者对其治疗的趣味性和有用性评价显著更高,并且对治疗的满意度也显著更高。在定性访谈中,参与者报告在一系列场景中使用了移动干预措施,包括在药物使用风险增加的时候,并发现它有助于控制药物渴望。此外,与接受标准MMT的参与者相比,试点参与者在3个月期间显示出治疗保留率提高和非法阿片类药物戒断的证据(就效应大小而言),这表明该应用程序有可能改善治疗效果。这些有前景的发现表明,一种基于证据的解决药物使用问题的移动治疗工具可能会吸引药物治疗服务对象,并作为正式治疗的辅助手段具有临床效用。

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