Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jun 5, 2020
Date Accepted: Mar 22, 2021
Feasibility and preliminary efficacy of community-Based Addiction Rehabilitation Electronic System in Substance Use Disorder: Pilot Randomized Controlled Trial
ABSTRACT
Background:
Drug use disorder has high potential to relapse and imposes an enormous burden on public health in China. Since the promulgation of the “Anti-drug law” in 2008, the community-based rehabilitation has become the primary approach to treat drug addiction. However, multi-faceted problems occurred in the implementation process, leading to low detoxification rate in the community. Mobile health (mHealth) serves as a promising tool to improve the effectiveness and efficiency of community-based rehabilitation. Community-based addiction rehabilitation electronic system (CAREs) is an interactive system for drug users and their corresponding social workers.
Objective:
The study aimed to examine the feasibility and preliminary efficacy of CAREs + community-based rehabilitation compared with the standard community-based rehabilitation from both the drug users and social workers perspective in Shanghai, China.
Methods:
In this pilot randomized controlled trial, 40 participants were recruited from the community in Shanghai from January to May 2019. Participants randomized to the intervention group (n=20) received CAREs + community-based rehabilitation, while participants in control group (n=20) received community-based rehabilitation alone for 6 months. Corresponding social workers provided service and monitored their drug use behavior as usual. The primary outcome was the feasibility of CAREs, which was reflected in the overall proportion and frequency of CAREs features used in both app and webpage end. The secondary outcomes were the effectiveness of CAREs, including the percentage of drug-positive samples, longest period of abstinence, contact times with social workers and the change of Addiction Severity Index (ASI) from baseline in the 6th month.
Results:
The number of participants logged in the app ranged from 7 to 20 per week and CAREs had high levels of continued patient use. Among the multiple features of CAREs, data of assessment and education features in app end and urine results record and viewing assessments results in webpage end indicated high levels of utilization. After 6-month intervention, 3.3% samples in the intervention group and 7.5% in the control group were drug-positive (F = 4.358, P= .04). No significant differences between the control and intervention group in terms of longest duration of abstinence, contact times and ASI composite scores.
Conclusions:
The study preliminarily demonstrated that with relatively good feasibility and acceptability, CAREs may improve the effectiveness and efficiency of the community-based rehabilitation, which provided instruction for further improvement of the system. Clinical Trial: ClinicalTrials.gov number: NCT03451344; https://clinicaltrials.gov/ct2/show/ NCT03451344 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/ NCT03451344)
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.