Monash Addiction Research Centre, Eastern Health Clinical School, Monash University.
Turning Point, Eastern Health, Melbourne, Australia.
Curr Opin Psychiatry. 2022 Jul 1;35(4):237-245. doi: 10.1097/YCO.0000000000000800. Epub 2022 Jun 9.
New mHealth (smartphone) apps for substance use disorders (SUD) are emerging at an accelerated rate, with consumer choice typically guided by app-store user ratings rather than their effectiveness. The expansive reach, low-cost and accessibility of mHealth apps have driven their popularity and appeal as alternatives to traditional treatment; as such, rigorously establishing their effectiveness is of paramount importance.
Several systematic reviews conclude that the evidence-base for mHealth SUD apps is weak, inconclusive and hampered by substantial heterogeneity in study designs. However, there have been a number of interesting and novel developments in this area in recent years, which have not been synthesised to date.
Most mHealth apps deliver either multiple-component behaviour change techniques, discrete psychological interventions or cognitive training interventions, or are designed to act as adjuncts to facilitate the delivery of clinical or continuing care. There are promising signals of their feasibility, acceptability and preliminary effectiveness in numerous open-label pilot studies of mHealth apps targeting alcohol and smoking. However, only a handful of sufficiently-powered, well-designed randomised controlled trials have been conducted to date with mixed findings. Furthermore, there has been limited recent attention on mHealth apps aiming to improve outcomes for individuals using other drugs.
目的综述:新的移动健康(智能手机)应用程序(app)针对物质使用障碍(SUD)呈加速出现,消费者的选择通常由应用程序商店的用户评分来指导,而不是由其有效性来指导。移动健康 app 的广泛覆盖范围、低成本和可及性使其作为传统治疗的替代品而广受欢迎;因此,严格确定其有效性至关重要。
最新发现:一些系统综述的结论认为,移动健康 SUD app 的证据基础薄弱、结论不确定,并且受到研究设计中存在显著异质性的阻碍。然而,近年来该领域有许多有趣和新颖的发展,迄今为止尚未对其进行综合分析。
总结:大多数移动健康 app 提供多种行为改变技术、离散心理干预或认知训练干预,或者旨在作为辅助手段来促进临床或持续护理的提供。针对酒精和吸烟的移动健康 app 的许多开放标签试点研究表明,它们具有可行性、可接受性和初步有效性的积极信号。然而,迄今为止,只有少数足够数量、精心设计的随机对照试验已经进行,结果喜忧参半。此外,最近对旨在改善使用其他药物的个体结果的移动健康 app 的关注有限。