Johnston Darcie C, Mathews W David, Maus Adam, Gustafson David H
Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, USA.
Red River Gorge Institute, Campton, KY, USA.
Subst Abuse. 2019 Jul 8;13:1178221819861377. doi: 10.1177/1178221819861377. eCollection 2019.
Longer retention in treatment is associated with positive outcomes. For women, who suffer worse drug-related problems than men, social technologies, which are more readily adopted by women, may offer promise. This naturalistic study examined whether a smartphone-based relapse-prevention system, A-CHESS (Addiction-Comprehensive Health Enhancement Support System), could improve retention for women with substance use disorders in an impoverished rural setting.
A total of 98 women, age 18 to 40, in southeastern Kentucky and mandated to treatment, received A-CHESS with intensive outpatient treatment for 6 months. For comparison, data were obtained for a similar but non-equivalent group of 100 same-age women also mandated to treatment in the same clinics during the period. Electronic medical record data on length-of-stay and treatment service use for both groups were analyzed, with A-CHESS use data, to determine whether those using A-CHESS showed better retention than those without.
Women with A-CHESS averaged 780 service units compared with 343 for the comparison group. For those with discharge dates prior to the study's end, A-CHESS patients stayed in treatment a mean of 410 vs 262 days for the comparison group.
Given associations between retention and positive outcomes, mobile health technology such as A-CHESS may help improve outcomes among women, especially in settings where access to in-person services is difficult. The findings, based on a non-equivalent comparison, suggest the need for further exploration with rigorous experimental designs to determine whether and to what degree access to a smartphone with A-CHESS may extend and support recovery for women.
治疗时间更长与积极结果相关。对于比男性遭受更严重药物相关问题的女性而言，女性更易采用的社交技术可能带来希望。这项自然主义研究考察了基于智能手机的预防复发系统A-CHESS（成瘾综合健康增强支持系统）能否提高贫困农村地区患有物质使用障碍的女性的治疗留存率。
肯塔基州东南部98名年龄在18至40岁且被强制要求接受治疗的女性，在接受强化门诊治疗的6个月期间使用A-CHESS。作为对照，获取了同一时期在相同诊所接受治疗的100名年龄相仿但不具有可比性的女性的数据。分析了两组的电子病历中关于住院时长和治疗服务使用的数据以及A-CHESS的使用数据，以确定使用A-CHESS的女性是否比未使用的女性有更好的治疗留存率。
使用A-CHESS的女性平均接受了780个服务单元的治疗，而对照组为343个。对于那些在研究结束前出院的患者，使用A-CHESS的患者平均住院410天，而对照组为262天。
鉴于治疗留存率与积极结果之间的关联，像A-CHESS这样的移动健康技术可能有助于改善女性的治疗结果，尤其是在难以获得面对面服务的环境中。基于非对等比较的研究结果表明，需要通过严谨的实验设计进行进一步探索，以确定使用配备A-CHESS的智能手机是否以及在何种程度上可以延长并支持女性的康复。
