Scialanca Madison, Alexander Karen, Tofighi Babak
Friends Research Institute, Social Research Center, 1040 Park Ave, Ste. 103, Baltimore, MD, 21201, United States, 1 4108373977.
J Med Internet Res. 2025 Jul 11;27:e69538. doi: 10.2196/69538.
A total of 60% of patients with opioid use disorder (OUD) leave treatment early. Psychosocial interventions can enhance treatment retention by addressing behavioral and mental health needs related to early treatment discontinuation, but intervention engagement is key. If well-designed, digital platforms can increase the engagement, reach, and accessibility of psychosocial interventions. Prior reviews of OUD treatment have predominantly focused on outcomes, such as reductions in substance use, without identifying the underlying behavior change principles that drive the effectiveness of interventions.
This scoping review aims to document and describe recent digital psychosocial interventions, including their behavior change strategies, for patients receiving medication for OUD (MOUD).
Predefined search terms were used to search Ovid, CINAHL, and PubMed databases for peer-reviewed literature published in the last 10 years. The database search resulted in 1381 relevant studies, and 16 of them remained after applying the inclusion criteria. Studies were included if they (1) evaluated a digital intervention with behavioral, psychosocial, or counseling components for people in OUD treatment and (2) were published in English in peer-reviewed journals.
The 16 studies reviewed comprised 6 randomized controlled trials, 6 pilot studies, 2 qualitative studies, and 2 retrospective cohort studies. Smartphone apps (n=8) were the most prevalent intervention delivery method, with other studies using telemedicine (n=3), virtual reality (n=1), telephone calls (n=1), or text messaging (n=3) to deliver psychosocial interventions in either a synchronous (n=7) or asynchronous (n=9) manner. The digital interventions reviewed predominately delivered cognitive behavioral therapy education through a phone call (n=1), a text message (n=2), a smartphone app (n=7), or tele-counseling (n=1). The predominant behavior change strategies implemented were self-monitoring, feedback and reinforcement, psychoeducation, cue awareness, and providing instruction. One intervention reviewed uses the evidence base of mindfulness-oriented recovery enhancement.
Participants in the studies reviewed indicated a preference for digital, flexible, patient-centered psychosocial interventions that emphasized improved patient-provider relationships. While randomized controlled trials comprised a significant portion of the studies, the inclusion of pilot studies and qualitative research highlights the field's ongoing exploration of feasibility and effectiveness. These findings underscore the growing role of digital health solutions in psychosocial care, though further research is needed to optimize engagement, delivery, and long-term outcomes.
共有60%的阿片类药物使用障碍(OUD)患者提前终止治疗。心理社会干预可以通过满足与早期治疗中断相关的行为和心理健康需求来提高治疗保留率,但干预参与是关键。如果设计得当,数字平台可以提高心理社会干预的参与度、覆盖面和可及性。先前对OUD治疗的综述主要集中在结果上,如物质使用的减少,而没有确定驱动干预有效性的潜在行为改变原则。
本范围综述旨在记录和描述最近针对接受阿片类药物使用障碍药物治疗(MOUD)的患者的数字心理社会干预措施,包括其行为改变策略。
使用预定义的搜索词在Ovid、CINAHL和PubMed数据库中搜索过去10年发表的同行评审文献。数据库搜索产生了1381项相关研究,应用纳入标准后其中16项保留。纳入的研究需满足以下条件:(1)评估针对OUD治疗患者的具有行为、心理社会或咨询成分的数字干预措施;(2)在同行评审期刊上以英文发表。
所审查的16项研究包括6项随机对照试验、6项试点研究、2项定性研究和2项回顾性队列研究。智能手机应用程序(n = 8)是最普遍的干预交付方式,其他研究使用远程医疗(n = 3)、虚拟现实(n = 1)、电话(n = 1)或短信(n = 3)以同步(n = 7)或异步(n = 9)方式提供心理社会干预。所审查的数字干预措施主要通过电话(n = 1)、短信(n = 2)、智能手机应用程序(n = 7)或远程咨询(n = 1)提供认知行为疗法教育。实施的主要行为改变策略包括自我监测、反馈与强化、心理教育、线索意识和提供指导。一项审查的干预措施采用了以正念为导向的康复增强的证据基础。
所审查研究的参与者表示倾向于数字、灵活、以患者为中心的心理社会干预措施,这些措施强调改善患者与提供者的关系。虽然随机对照试验在研究中占很大比例,但纳入试点研究和定性研究突出了该领域对可行性和有效性的持续探索。这些发现强调了数字健康解决方案在心理社会护理中日益重要的作用,不过仍需要进一步研究以优化参与度、交付方式和长期结果。