伊朗阿片类药物维持治疗患者的混合智能手机干预：随机对照试验方案。

Blended smartphone intervention for patients in opioid maintenance treatment in Iran: protocol for a randomized controlled trial.

机构信息

Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, 8005, Zurich, Switzerland.

Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

BMC Psychiatry. 2023 Jul 18;23(1):518. doi: 10.1186/s12888-023-05007-0.

DOI:10.1186/s12888-023-05007-0

PMID:37464337

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10354992/

Abstract

BACKGROUND

The pattern of substance use in Iran is characterized by a high prevalence of opioid use and opioid use disorder (OUD). Although opioid maintenance therapy (OMT) has been introduced in Iran, approximately 50% of people with opioid use disorder remain unreached. Moreover, psychosocial treatment of OUD and common mental health symptoms during OMT is limited. Digital interventions have been shown to improve psychological distress, depression, anxiety, and post-traumatic stress disorder symptoms. In addition, providing psychoeducation and risk reduction counseling to prevent communicable diseases like HIV and infectious hepatitis is common via the Internet. However, despite these promising advances, no smartphone intervention in OMT has been investigated for the treatment of OUD and common comorbid mental health symptoms.

OBJECTIVE

We examine the effectiveness of adding a blended smartphone intervention based on community reinforcement approach, motivational interviewing- and cognitive behavioral therapy compared to OMT as usual that aims to improve OMT outcomes and addresses common mental health symptoms in OMT patients in Iran.

METHOD

Adults with opioid dependence entering 8 treatment centers in Tehran, Iran will be randomly assigned to receive either OMT plus a smartphone intervention or OMT as usual. The primary outcomes will be the percentage of negative urine tests for illicit, non-prescribed use of opioids (opium, heroin, tramadol) and treatment retention. Secondary outcomes will include the longest period of abstinence from the illicit, non-prescribed use of opioids (opium, heroin, and tramadol) confirmed by urine samples, changes in communicable disease risk-taking behaviors, changes in stress and common mental health symptoms, and client satisfaction. Data analysis will follow the intention-to-treat principle and employ (generalized) linear mixed models.

DISCUSSION

This study will provide substantial knowledge for designing effective blended interventions for OUD. Moreover, it will investigate if treatment retention and OMT-related outcomes and common mental health symptoms can be improved by adding a smartphone intervention to OMT.

TRIAL REGISTRATION

https://en.irct.ir/trial/53578 .

摘要

背景

伊朗的物质使用模式以阿片类药物使用和阿片类药物使用障碍（OUD）的高患病率为特征。尽管伊朗已经引入了阿片类药物维持治疗（OMT），但仍有约 50%的 OUD 患者未得到治疗。此外，OMT 期间 OUD 的心理社会治疗和常见精神健康症状的治疗也很有限。数字干预已被证明可以改善心理困扰、抑郁、焦虑和创伤后应激障碍症状。此外，通过互联网提供预防艾滋病毒和传染性肝炎等传染病的心理教育和减少风险咨询是很常见的。然而，尽管这些进展令人鼓舞，但尚未研究过智能手机干预 OMT 治疗 OUD 和常见合并精神健康症状。

目的

我们研究了在伊朗，与 OMT 常规治疗相比，添加基于社区强化方法、动机访谈和认知行为治疗的混合智能手机干预对改善 OMT 结果和解决 OMT 患者常见精神健康症状的效果。

方法

将进入伊朗德黑兰 8 个治疗中心的阿片类药物依赖成年人随机分配接受 OMT 加智能手机干预或 OMT 常规治疗。主要结果将是非法、非处方使用阿片类药物（鸦片、海洛因、曲马多）的尿液检测呈阴性的比例和治疗保留率。次要结果将包括最长的非法、非处方使用阿片类药物（鸦片、海洛因和曲马多）的禁欲期，由尿液样本证实，传染病风险行为的变化，压力和常见精神健康症状的变化，以及患者满意度。数据分析将遵循意向治疗原则，并采用（广义）线性混合模型。