JMIR Publications

ABSTRACT

Background:

Addiction is a worldwide problem with major health complications. Despite intensive treatments, relapse rates remain high. Prevalence of cognitive impairments is high in patients with substance use disorders (SUDs) and is associated with treatment dropout and relapse. There is evidence that training cognitive functions in persons with SUD may support treatment. The use of online tools to test and train cognitive functions is therefore of increasing interest.

Objective:

The goal of this study was to determine the feasibility and acceptability of a serious gaming smartphone application as an addition to the treatment of SUDS.

Methods:

A prospective observational study was conducted among 229 patients seeking treatment in an addiction treatment center in The Netherlands. Patients were offered two smartphone applications in addition to regular care. ‘MyCognition Quotient’ (MyCQ) assessed cognitive functions; AquaSnap trained these functions. Feasibility was determined by acceptance rates. Acceptability was measured by a questionnaire. Patient characteristics were compared between patients who did and who did not play the smartphone games. Acceptability of the smartphone applications was qualitatively analyzed on the basis of the answers to the questionnaires.

Results:

Of the 229 patients who were offered the applications, 110 completed the MyCQ assessment and 59 started playing AquaSnap, yielding acceptance rates of 48% and 25% respectively. The group that completed the MyCQ assessment was significantly higher educated than the group that did not download the applications (χ2=7, P =.03). Near-significant findings in the same direction for educational differences between the group that played AquaSnap and the group that did not play Aquasnap were present (P=.06). The groups did not differ on age, gender distribution, substance use, treatment setting, mood or quality of life. With respect to acceptability, 83% enjoyed taking the MyCQ measurement, while 41% enjoyed playing the AquaSnap game. 76% (MyCQ) and 68% (AquaSnap) rated the app as easy.

Conclusions:

Our study shows that the use of a smartphone application for cognitive assessment in patients with substance use disorder is feasible and acceptable. However, the use of a smartphone application for cognitive training via serious gaming was less feasible in this group of patients. Improvement of the application and of the motivation of the clients is needed. Despite these limitations, the present results provide support for future research investigating the use of smartphone applications for cognitive assessment and cognitive training in relation to the treatment of SUDs.