Bahadoor Rubaab, Alexandre Jean-Marc, Fournet Lucie, Gellé Thibaut, Serre Fuschia, Auriacombe Marc
University of Bordeaux, Bordeaux, France.
Addiction Team Phenomenology and Determinants of Appetitive Behaviors, Sanpsy CNRS USR 3413, Bordeaux, France.
Front Psychiatry. 2021 Feb 22;12:622394. doi: 10.3389/fpsyt.2021.622394. eCollection 2021.
Less than 20% of people with addictions have access to adequate treatment. Mobile health could improve access to care. No systematic review evaluates effectiveness of mobile health applications for addiction. First aim was to describe controlled trials evaluating the effectiveness of smartphone applications targeting substance use disorders and addictive behaviors. Secondly, we aimed to understand how the application produced changes in behavior and craving management. A systematic review based on PRISMA recommendations was conducted on MEDLINE, CENTRAL, and PsycINFO. Studies had to be controlled trials concerning addictive disorders (substance/behavior), mobile application-based interventions, assessing effectiveness or impact of those applications upon use, published after 2008. Relevant information was systematically screened for synthesis. Quality and risk of bias were evaluated with JADAD score. Search strategy retrieved 22 articles (2014-2019) corresponding to 22 applications targeting tobacco, alcohol, other substances and binge eating disorder. Control groups had access to usual treatments or a placebo-application or no treatment. Eight applications showed reduced use. Most of the applications informed about risks of use and suggestions for monitoring use. Twelve applications managed craving. Heterogeneity limited study comparisons. Duration of studies was too short to predict sustainable results. A reduction of craving seemed related to a reduction in use. There is a lack of robust and comparable studies on mHealth applications for addiction treatment. Such applications could become significant contributors in clinical practice in the future so longer-termed double-blind studies are needed. Targeting craving to prevent relapse should be systematic.
成瘾者中只有不到20%的人能够获得充分的治疗。移动健康可以改善医疗服务的可及性。尚无系统评价评估移动健康应用程序对成瘾治疗的有效性。首要目标是描述评估针对物质使用障碍和成瘾行为的智能手机应用程序有效性的对照试验。其次，我们旨在了解这些应用程序如何在行为和渴望管理方面产生变化。基于PRISMA建议，对MEDLINE、CENTRAL和PsycINFO进行了系统评价。研究必须是关于成瘾性障碍（物质/行为）、基于移动应用程序的干预措施、评估这些应用程序使用时的有效性或影响的对照试验，且发表于2008年之后。对相关信息进行系统筛选以进行综合分析。使用JADAD评分评估质量和偏倚风险。检索策略检索到22篇文章（2014 - 2019年），对应22种针对烟草、酒精、其他物质和暴饮暴食障碍的应用程序。对照组可以获得常规治疗、安慰剂应用程序或不接受治疗。8种应用程序显示使用量减少。大多数应用程序告知了使用风险和监测使用的建议。12种应用程序可管理渴望。异质性限制了研究间的比较。研究持续时间过短，无法预测可持续的结果。渴望的减少似乎与使用量的减少有关。关于移动健康应用程序用于成瘾治疗，缺乏有力且可比的研究。此类应用程序未来可能会在临床实践中发挥重要作用，因此需要进行更长期的双盲研究。系统性地针对渴望以预防复发是必要的。
