JMIR Publications

ABSTRACT

Background:

Research shows that improvements in coping strategies, abstinence self-efficacy, craving, and depression are potential mechanisms of behavioral change (MOBCs) in several treatments for substance use disorders (SUDs). Yet, little is known about how these insights about MOBCs will be incorporated into frontline SUD treatment settings. One way to facilitate MOBC-informed care in frontline settings could be to measure and monitor changes in MOBCs throughout treatment using brief, frequent questionnaires completed by patients using mobile technologies (e.g., smartphones). The results of these questionnaires could potentially be used for clinical monitoring (i.e., measurement-based care) to understand whether individual patients are experiencing treatment-related improvements on key clinical targets.

Objective:

This study evaluated whether brief, weekly MOBC questionnaires completed remotely by patients can potentially provide clinically meaningful information about changes in MOBCs in the context of real-world, community-based SUD treatment.

Methods:

Thirty patients in a community substance use treatment clinic participated in the pilot study and were invited to complete brief questionnaires that assessed MOBCs remotely (via smartphone) every week for 6 months (n=618 questionnaires completed in total). Participants also completed longer, psychometrically validated measures of MOBCs at baseline and 6-month research appointments.

Results:

Analyses indicated that brief, weekly, remotely-completed, patient-report MOBC measures (1) varied longitudinally (within patients) more than measures of alcohol and drug consumption, (2) typically had medium-to-large cross-sectional and longitudinal correlations with longer psychometrically measures of MOBCs completed at research appointments, and (3) generally had similar patterns of association with 6-month percentage of days abstinent from alcohol and drugs as longer psychometrically validated MOBC measures completed at research appointments.

Conclusions:

Results of this pilot study provide initial evidence that incorporating brief, weekly, remotely completed, patient-report MOBC assessments into community SUD treatment may be a viable approach to facilitating MOBC-informed care. Such assessments can potentially provide meaningful information about within-patient changes in clinical domains that are often directly targeted in SUD treatments and that predict longer-term substance use outcomes. Clinical Trial: Not applicable