Muhlner Kristin, DeFlavio Jeff, Ang Alfonso, Zito Michael, McLellan A Thomas, Perrochet Brian
Affect Therapeutics, Inc., New York, NY, United States.
UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, United States.
Front Psychiatry. 2023 Jul 13;14:1176641. doi: 10.3389/fpsyt.2023.1176641. eCollection 2023.
This study assessed the feasibility and utility of a digital, all-virtual program designed for treatment of methamphetamine use disorder (MUD). Forty-nine adults with moderate- to severe-level MUD (per DSM-5 criteria) commenced the 8-week intervention. All aspects of the program were delivered via smartphone-based app. Intervention components included counseling (cognitive behavioral therapy in group and individual sessions), app-based therapeutic tasks, remote biological drug testing, medical oversight by psychiatrists/nurse practitioners, and contingency management procedures (including rewards for methamphetamine-free saliva drug tests, accomplishing tasks, and engaging in assigned activities). Of the 49 participants who commenced treatment, 27 participants (55%) completed the program. Repeated-measures mixed-model analyses show that participants were more likely to test negative for meth use from week 1 to week 8 (OR = 1.57, 95% CI [1.28, 1.97]; = 0.034). Well-being and social functioning improved among the majority of participants. These results demonstrate the utility of the all-virtual, digital therapeutic program and its ability to help individuals with MUD to reduce or cease methamphetamine use. The program was efficiently implemented and was well received by participants and clinical personnel, indicating its ability to deliver comprehensive, effective care and to retain the difficult-to-engage population of persons with MUD. Of the 27 completers, 16 responded to a 1-month follow-up survey and reported no meth use in the month since completing the program.
本研究评估了一项专为治疗甲基苯丙胺使用障碍（MUD）设计的全虚拟数字项目的可行性和实用性。49名符合中度至重度MUD（根据《精神疾病诊断与统计手册》第5版标准）的成年人开始了为期8周的干预。该项目的所有方面均通过基于智能手机的应用程序提供。干预内容包括咨询（团体和个体认知行为疗法）、基于应用程序的治疗任务、远程生物药物检测、精神科医生/执业护士的医疗监督以及应急管理程序（包括对甲基苯丙胺唾液检测呈阴性、完成任务和参与指定活动的奖励）。在开始治疗的49名参与者中，27名参与者（55%）完成了该项目。重复测量混合模型分析表明，从第1周到第8周，参与者甲基苯丙胺检测呈阴性的可能性更大（OR = 1.57，95%CI [1.28, 1.97]；P = 0.034）。大多数参与者的幸福感和社会功能得到改善。这些结果证明了全虚拟数字治疗项目的实用性及其帮助患有MUD的个体减少或停止使用甲基苯丙胺的能力。该项目实施高效，受到参与者和临床人员的好评，表明其有能力提供全面、有效的护理，并留住难以参与治疗的MUD患者群体。在27名完成者中，16名对1个月的随访调查做出了回应，并报告自完成项目后的一个月内未使用甲基苯丙胺。
