Department of Psychiatry, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI 48109, United States of America; VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2800 Plymouth Rd, Ann Arbor, MI 48109, United States of America.
University of California San Diego, Health Services Research Center, Department of Family Medicine and Public Health, 9500 Gilman Drive, La Jolla, CA 92093, United States of America.
J Subst Abuse Treat. 2019 Jun;101:38-49. doi: 10.1016/j.jsat.2019.03.007. Epub 2019 Mar 21.
With increased negative impacts from opioid and other substance use disorders in the US, it is important for treatments to not only be effective, but also accessible to patients. Treatment delivery via telemedicine, specifically, the use of videoconferencing, which allows real time communication between a patient and a clinician at a distant site, has been shown to be an effective approach for increasing reach and access to treatments for mental health disorders and other chronic illnesses. This systematic review identified and summarized studies examining the effectiveness of telemedicine interventions to deliver treatment for patients with substance use disorders. Out of 841 manuscripts that met our search criteria, 13 studies met the inclusion criteria. Studies covered interventions for nicotine, alcohol and opioid use disorders. They varied widely in size, quality, and in the comparison groups examined. Studies examined both delivery of psychotherapy and medication treatments. Most studies suggested telemedicine interventions were associated with high patient satisfaction and are an effective alternative, especially when access to treatment is otherwise limited. However, there were substantial methodological limitations to the research conducted to date. Further studies are needed, including larger scale randomized studies that examine different models of telemedicine that can be integrated into existing healthcare delivery settings, to increase the use of effective treatments for patients with substance use disorders.
随着阿片类药物和其他物质使用障碍在美国的负面影响不断增加，治疗方法不仅要有效，而且要让患者能够获得，这一点非常重要。远程医疗（特别是使用视频会议，使患者和远程站点的临床医生能够实时进行沟通）的治疗提供方式已被证明是一种有效的方法，可以增加心理健康障碍和其他慢性疾病的治疗的可及性和覆盖面。本系统评价确定并总结了研究远程医疗干预措施对治疗物质使用障碍患者的有效性的研究。在符合我们搜索标准的 841 篇手稿中，有 13 项研究符合纳入标准。研究涵盖了尼古丁、酒精和阿片类物质使用障碍的干预措施。它们在规模、质量和所检查的对照组方面差异很大。研究检查了心理治疗和药物治疗的提供情况。大多数研究表明，远程医疗干预措施与患者的高度满意度相关，是一种有效的替代方法，特别是在治疗机会受到限制的情况下。然而，迄今为止进行的研究存在重大方法学限制。需要进一步的研究，包括更大规模的随机研究，以检查可以整合到现有医疗保健提供环境中的不同模式的远程医疗，以增加对物质使用障碍患者的有效治疗的使用。
