Elson S. Floyd College of Medicine, Washington State University, PO Box 1495, Spokane, WA, 99210-1495, USA.
Analytics and PsychoPharmacology Laboratory (APPL), Spokane, WA, USA.
Addict Sci Clin Pract. 2022 Mar 26;17(1):20. doi: 10.1186/s13722-022-00301-w.
Alcohol use increases risk for morbidity and mortality and is associated with over 3 million annual deaths worldwide. Contingency Management (CM) is one of the most effective interventions for substance use disorders, and has recently been coupled with technologies to promote novel treatments for alcohol use disorders (AUD). Leveraging these technological advances, we are developing the Automated Reinforcement Management System (ARMS), an integrated CM system designed to enable CM treatment as a component of a digital therapeutic or adjunct therapy remotely to anyone with a smartphone.
To collect detailed provider feedback on ARMS and determine the need for modifications to make the system most feasible, acceptable, and useful to providers.
Seven providers completed one-hour structured interviews/focus groups wherein we described the ARMS system and its application to clinical care. Providers viewed screen shots of the ARMS provider facing and patient facing systems. Providers gave feedback on their current AUD treatment practices, preferences for the functionality and appearance of the system, preferences for receipt of information on their patients, why they and their patients would or would not use the system, suggestions for improvement, and the proposed intervention overall. To analyze the qualitative data gathered, we used a qualitative descriptive approach with content analysis methods.
The overarching theme of Individualized Treatment emerged throughout the interviews. This sentiment supports use of ARMS, as it is intended to supplement provider communication and intervention as an adjunctive and customizable tool with the ability to reach rural patients, not a stand-alone option. Themes of Accountability and Objective Assessment arose during discussions of why people would use the system. Themes within provider obstacles included, Information Overload and Clinical Relevance, and in patient obstacles, Sustained Engagement and Security Concerns. Two themes emerged regarding suggestions for improvement: Increasing Accessibility and Bi-directional Communication.
Themes from provider input are being used to modify ARMS to make it more user friendly, time saving, and relevant to treatment of AUD. If successful, ARMS will provide effective, individualized-digital therapeutic for those needing adjunctive treatment or those living in rural remote areas needing better connected care.
饮酒会增加发病和死亡的风险，与全球每年 300 多万人的死亡有关。 contingencymanagement （ CM ）是治疗物质使用障碍最有效的干预措施之一，最近已与技术相结合，以促进治疗酒精使用障碍（ AUD ）的新方法。 利用这些技术进步，我们正在开发自动强化管理系统（ ARMS ），这是一个集成的 CM 系统，旨在使 CM 治疗成为数字治疗或辅助治疗的一部分，以便任何使用智能手机的人都能远程接受治疗。
收集有关 ARMS 的详细提供者反馈，并确定需要进行修改以使系统对提供者最可行、可接受和有用的地方。
七名提供者完成了一个小时的结构化访谈/焦点小组，我们在其中描述了 ARMS 系统及其在临床护理中的应用。 提供者查看了 ARMS 提供者面对和患者面对系统的屏幕截图。 提供者就其当前的 AUD 治疗实践、对系统功能和外观的偏好、接收有关其患者信息的偏好、他们和他们的患者为何会或不会使用该系统、改进建议以及总体建议干预措施提供了反馈。 为了分析收集到的定性数据，我们使用了定性描述方法和内容分析方法。
整个访谈过程中出现的主题是“个体化治疗”。 这种情绪支持使用 ARMS ，因为它旨在作为一种补充，作为一种补充性和可定制的工具，与提供者的沟通和干预相结合，具有接触农村患者的能力，而不是一个独立的选择。 在讨论人们为什么会使用该系统时出现了问责制和客观评估的主题。 提供者障碍的主题包括信息过载和临床相关性，以及患者障碍，持续参与和安全问题。 关于改进建议有两个主题出现：提高可访问性和双向沟通。
提供者的意见主题正在被用来修改 ARMS ，以使它更用户友好，节省时间，并且与 AUD 的治疗相关。 如果成功，ARMS 将为那些需要辅助治疗或那些生活在农村偏远地区需要更好的联系护理的人提供有效的、个性化的数字治疗。
