Kmiec Julie, Suffoletto Brian
Department of Psychiatry, University of Pittsburgh, United States of America.
Department of Emergency Medicine, University of Pittsburgh School of Medicine, United States of America.
J Subst Abuse Treat. 2019 May;100:39-44. doi: 10.1016/j.jsat.2019.02.005. Epub 2019 Feb 21.
To determine acceptability and explore potential usefulness of a text messaging (SMS) program aimed at increasing attendance at outpatient treatment for substance use disorders (SUD) after emergency department (ED) referral.
A retrospective analysis of 377 adult patients from 2 urban EDs seeking treatment for SUD (opioids (n = 168), alcohol (n = 188), benzodiazepines (n = 21)) referred to outpatient treatment and offered an SMS program which included daily (1) motivational messages focused on positive thinking, (2) ecological momentary assessments (EMA) related to craving with tailored behavioral strategy messages, (3) EMA of drug use with tailored feedback to reduce abstinence violation effects, and (4) reminders about treatment location and phone number. We assessed acceptability by examining opt-in rates, EMA completion rates over the first week and end-of-program qualitative feedback. We assessed how individuals who opt in differ in outcomes from those who opt out by examining rates of outpatient SUD treatment attendance recorded from the medical record.
167 patients (44%) opted in to the SMS program. Over 7 days, around 33% of EMA were completed. Median helpfulness score was 8 (IQR 6 to 10) out of 10 and 84% would recommend the SMS program to someone else. Individuals who opted in to the SMS program had higher rates of SUD treatment initiation than individuals who did not opt-in (70.7% vs. 40.9%).
We found evidence supporting acceptability and potential usefulness of an automated text message program to assist treatment attendance for some individuals with SUDs discharged from the ED. A controlled trial is needed to examine whether SMS program exposure is associated with improved treatment attendance compared to standard care.
确定一项旨在提高急诊科（ED）转诊后物质使用障碍（SUD）门诊治疗出勤率的短信（SMS）计划的可接受性，并探索其潜在效用。
对来自两家城市急诊科的377名寻求SUD治疗的成年患者进行回顾性分析（阿片类药物（n = 168）、酒精（n = 188）、苯二氮䓬类药物（n = 21）），这些患者被转诊至门诊治疗并提供了一个短信计划，该计划包括每日（1）专注于积极思考的激励信息，（2）与渴望相关的生态瞬时评估（EMA）及量身定制的行为策略信息，（3）药物使用的EMA及量身定制的反馈以减少戒断违规效应，以及（4）治疗地点和电话号码提醒。我们通过检查加入率、第一周的EMA完成率和计划结束时的定性反馈来评估可接受性。我们通过检查病历中记录的门诊SUD治疗出勤率，评估加入者与未加入者在结果上的差异。
167名患者（44%）加入了短信计划。在7天内，约33%的EMA完成。帮助得分中位数为8（四分位间距为6至10）（满分10分），84%的人会向他人推荐该短信计划。加入短信计划的个体SUD治疗开始率高于未加入者（70.7%对40.9%）。
我们发现有证据支持自动短信计划对协助某些从急诊科出院的SUD患者的治疗出勤率具有可接受性和潜在效用。需要进行一项对照试验，以检查与标准护理相比，接触短信计划是否与改善治疗出勤率相关。
