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临床医生对将智能手机应用程序数据整合到常规酒精依赖治疗中的看法:影响实施的因素

Clinicians' perspectives on integrating smartphone application data into routine alcohol dependency treatment: factors influencing implementation.

作者信息

Östh Josefine, Lundin Andreas, Wennberg Peter, Andréasson Sven, Danielsson Anna-Karin

机构信息

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

Centre for Epidemiology and Community Health, Region Stockholm, Stockholm, Sweden.

出版信息

Addict Sci Clin Pract. 2025 Aug 13;20(1):66. doi: 10.1186/s13722-025-00597-4.

Abstract

BACKGROUND

Incorporating clinicians' perspectives is essential for the successful implementation of novel interventions in health care. This study aimed to explore clinicians' experiences of using smartphone-derived data in alcohol dependency treatment, and factors affecting implementation into routine care.

METHODS

Two focus group discussions were conducted in April 2023, including 10 clinicians working at a specialist addiction clinic in Stockholm, Sweden. The clinicians had various levels of experience using smartphone-based data, which was available through two online portals, as part of a randomised controlled trial evaluating two smartphone-based interventions. Data were analysed using Thematic Framework Analysis, guided by Normalisation Process Theory.

RESULTS

Two main themes were identified: The patient as the driving force and Cultivating commitment, competence and credibility. The first theme highlighted a person-centred approach that permeated the practice and how the patients' engagement with the app-based interventions guided the clinicians' own involvement. Benefits of the interventions for both patients (i.e., increased awareness and control) and clinicians (i.e. supportive during treatment sessions) were also acknowledged. Clinicians believed that the interventions offered an opportunity for patients to become more actively involved in treatment and noted that clinician access to the app-derived data was less important. The second theme covered clinician discussions on the need for support and guidance to make better use of the interventions, continuity in the work, and additional work time. Moreover, the use of external portals made the intervention less accessible. Potential risks and concerns with the interventions were raised, including technical instability and data security.

DISCUSSION AND CONCLUSIONS

The results of this study indicate that a breathalyser-coupled and a drink-counting smartphone application have potential to be supportive complements to alcohol dependency treatment. According to the clinicians, the app-based interventions enhanced patient accountability in the change process and supported treatment delivery. To be effectively implemented into routine care, using a person-centred approach is key, as well as ensuring optimal conditions for clinicians to effectively use the systems. Technical issues constitute a barrier to acceptance, why technical robustness must be ensured.

摘要

背景

纳入临床医生的观点对于在医疗保健中成功实施新干预措施至关重要。本研究旨在探讨临床医生在酒精依赖治疗中使用智能手机衍生数据的经验,以及影响其纳入常规护理的因素。

方法

2023年4月进行了两次焦点小组讨论,参与者包括在瑞典斯德哥尔摩一家专业成瘾诊所工作的10名临床医生。这些临床医生使用基于智能手机数据的经验水平各不相同,这些数据可通过两个在线门户获取,作为一项评估两项基于智能手机干预措施的随机对照试验的一部分。数据采用主题框架分析法进行分析,并以规范化过程理论为指导。

结果

确定了两个主要主题:患者作为驱动力以及培养承诺、能力和可信度。第一个主题强调了贯穿实践的以人为本的方法,以及患者对基于应用程序干预措施的参与如何引导临床医生自身的参与。还承认了干预措施对患者(即提高意识和控制能力)和临床医生(即在治疗过程中提供支持)的益处。临床医生认为,这些干预措施为患者提供了更积极参与治疗的机会,并指出临床医生获取应用程序衍生数据的重要性较低。第二个主题涵盖了临床医生关于获得支持和指导以更好地利用干预措施、工作连续性以及额外工作时间的讨论。此外,使用外部门户使干预措施的获取性降低。还提出了干预措施的潜在风险和担忧,包括技术不稳定和数据安全。

讨论与结论

本研究结果表明,一款呼气酒精含量测定仪和一款饮酒计数智能手机应用程序有潜力成为酒精依赖治疗的辅助补充手段。临床医生认为,基于应用程序的干预措施增强了患者在改变过程中的责任感,并支持了治疗的实施。要有效纳入常规护理,以人为本的方法是关键,同时要确保临床医生有效使用系统的最佳条件。技术问题是接受度的障碍,因此必须确保技术稳健性。

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