Center for Clinical Excellence, ECRI, Plymouth Meeting, Pennsylvania (S.U., A.B., A.M., K.M., M.S.N., K.E.D.).
University of Pennsylvania, Philadelphia, Pennsylvania (J.R.M.).
Ann Intern Med. 2022 May;175(5):691-700. doi: 10.7326/M21-3931. Epub 2022 Mar 22.
Approximately 20.4 million Americans met criteria for a substance use disorder (SUD) in 2019; however, only about 12.2% of persons with an SUD receive specialty care. Telehealth offers alternatives to traditional forms of substance use treatment.
To synthesize recent findings on the efficacy of telehealth for SUDs.
MEDLINE, Embase, PubMed, and the Cochrane Library from January 2015 through August 2021 (English language only).
Randomized controlled trials (RCTs) of adults with a diagnosis of SUD based on the or International Classification of Diseases.
One investigator abstracted data and assessed study quality, and a second checked for accuracy.
This rapid review synthesized evidence from 17 RCTs. Evidence is very uncertain that telehealth provided as videoconference therapy (1 RCT) or web-based cognitive behavioral therapy (CBT) (3 RCTs) has similar effects to in-person therapy for improving abstinence from alcohol or cannabis. Low-strength evidence suggests that web-based CBT has similar effects for improving abstinence in multiple SUDs (2 RCTs). Low-strength evidence suggests that adding supportive text messaging to follow-up care improves abstinence and amount of alcohol per day (2 RCTs) but does not improve emergency department visits or frequency of consumption (2 RCTs). Enhanced telephone monitoring likely reduces readmissions for SUD detoxification compared with usual follow-up alone (1 RCT) but does not reduce days of substance use (low-strength evidence).
Narrative synthesis, heterogeneity of telehealth interventions, no assessment of publication bias, and study methodology.
Evidence is very uncertain that telehealth is similar to in-person care for SUD outcomes. Limited evidence suggests some benefit of adding telehealth to usual SUD care.
U.S. Department of Veterans Affairs Veterans Health Administration.
2019 年，约有 2040 万美国人符合物质使用障碍（SUD）的标准；然而，只有约 12.2%的 SUD 患者接受专业护理。远程医疗为传统的物质使用治疗提供了替代方案。
综合最近关于远程医疗治疗 SUD 的疗效的研究结果。
仅使用英语，从 2015 年 1 月到 2021 年 8 月，在 MEDLINE、Embase、PubMed 和 Cochrane Library 上进行检索。
基于 或国际疾病分类，对患有 SUD 诊断的成年人进行的随机对照试验（RCTs）。
一名调查员提取数据并评估研究质量，第二名调查员检查准确性。
这项快速综述综合了来自 17 项 RCT 的证据。有非常不确定的证据表明，远程医疗作为视频会议治疗（1 项 RCT）或基于网络的认知行为疗法（CBT）（3 项 RCT），在提高酒精或大麻戒断方面与面对面治疗效果相当。低强度证据表明，基于网络的 CBT 在改善多种 SUD 的戒断方面效果相当（2 项 RCT）。低强度证据表明，在随访护理中增加支持性短信可以提高戒断率和每天的饮酒量（2 项 RCT），但不能减少急诊就诊次数或饮酒频率（2 项 RCT）。增强型电话监测可能会降低 SUD 戒毒后的再入院率，与单独常规随访相比（1 项 RCT），但不能减少物质使用的天数（低强度证据）。
叙述性综合，远程医疗干预措施的异质性，未评估发表偏倚，以及研究方法。
关于远程医疗是否与 SUD 结果相似，证据非常不确定。有限的证据表明，将远程医疗添加到常规 SUD 护理中可能会有一些益处。
美国退伍军人事务部退伍军人健康管理局。
