Moore Brent A, Buono Frank D, Printz Destiny M B, Lloyd Daniel P, Fiellin David A, Cutter Christopher J, Schottenfeld Richard S, Barry Declan T
Department of Psychiatry, Yale University School of Medicine.
Department of Internal Medicine, Yale University School of Medicine.
Exp Clin Psychopharmacol. 2017 Dec;25(6):485-495. doi: 10.1037/pha0000149.
The Recovery Line is an automated, computer-based intervention based on cognitive behavioral therapy (CBT) designed to provide real-time assistance by phone for patients in methadone maintenance. Preliminary efficacy findings were promising, however, as with other computer-based systems for substance use disorder, patient system use was less than recommended. Development and evaluation of system functions to increase patient engagement and use is needed. Thus, we conducted two randomized trials to evaluate system functions designed to increase patient use of the Recovery Line among methadone-maintained patients with continued illicit drug use. In Trial 1 (n = 60), patients received customized, system use recommendations or no recommendations on each Recovery Line call. Ratings of system usability were higher for customized recommendations (CR), but number of calls and total call time did not differ by condition. Trial 2 evaluated characteristics of reminder messages (message frame and reminder latency). Participants (N = 67) received gain- and loss-frame reminder messages, and were randomly assigned to immediate, short, or long term message latency. Although message framing had no effect, gender interacted with latency condition such that females did not differ by message latency, while males had significantly greater total contact time in the short latency conditions. Number of calls differed by condition over time such that the shorter latencies led to greater calls initially, but dissipated over time. Overall the study indicates that computer-based self-management systems can be adapted to increase patient engagement and use. (PsycINFO Database Record
康复热线是一种基于认知行为疗法(CBT)的自动化计算机辅助干预措施,旨在通过电话为接受美沙酮维持治疗的患者提供实时帮助。初步疗效结果令人鼓舞,然而,与其他用于物质使用障碍的计算机系统一样,患者对系统的使用未达推荐水平。需要开发和评估系统功能以提高患者参与度和使用率。因此,我们进行了两项随机试验,以评估旨在增加持续使用非法药物的美沙酮维持治疗患者对康复热线使用的系统功能。在试验1(n = 60)中,患者在每次拨打康复热线时会收到定制的系统使用建议或无建议。定制建议(CR)的系统可用性评分更高,但通话次数和总通话时间在不同条件下并无差异。试验2评估了提醒信息的特征(信息框架和提醒延迟)。参与者(N = 67)收到收益框架和损失框架的提醒信息,并被随机分配到即时、短期或长期信息延迟条件。虽然信息框架没有影响,但性别与延迟条件存在交互作用,即女性在不同信息延迟条件下没有差异,而男性在短期延迟条件下的总联系时间显著更长。随着时间推移,通话次数因条件而异,即较短的延迟最初导致更多通话,但随着时间推移逐渐减少。总体而言,该研究表明基于计算机的自我管理系统可以进行调整以提高患者参与度和使用率。(PsycINFO数据库记录)