Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Jul 06, 2024)
Date Submitted: Dec 1, 2023
Open Peer Review Period: Dec 1, 2023 - Jan 29, 2024
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A systematic review of the effectiveness of conventional versus technology assisted cue exposure therapy for treating substance use disorders
ABSTRACT
Background:
Cue Exposure Therapy (CET) is a behavioristic psychological intervention for treating substance use disorders (SUDs. Recently, CET has been examined in technology-assisted formats to increase intervention effectiveness. No systematic review has examined the effectiveness of different CET formats across types of SUDs.
Objective:
We aimed to examine the effectiveness of CET across SUD types and examine the effectiveness of technology-assisted (T-CET) vs. non-technology-assisted CET (NT-CET).
Methods:
We conducted a systematic literature search in MEDLINE, PsycINFO, EMBASE, and the Cochrane Central Register of Controlled Trials up to March 2023. Two independent authors conducted the study selection using the review management software Covidence. The effectiveness of CET was inspected trough a qualitative synthesis and the quality assessment of all the included studies was performed using the Cochrane risk-of-bias tool for randomized trials, version 2.
Results:
Thirty-nine controlled trials were identified (NT-CET; n=21; T-CET: n=18). Compared to active control interventions, CET was found to be more effective in 39% of the studies (n=9/23) that examined cravings, and in 55% of the studies (n=12/22) that examined consumption. CET was most effective when combined with cognitive behavioral therapy (CBT) or CBT-related approaches. T-CET performed better than control interventions more often than NT-CET regarding both cravings (60% vs. 23%) and consumptions (75% vs. 43%), and the findings were more prominent when CET was delivered in virtual reality (VR) format.
Conclusions:
The systematic review demonstrated that CET may be most effective when combined with CBT-related approaches and delivered through T-CET, particularly VR. Future high-quality studies comparing different CET delivery formats are warranted to enable more firm conclusions and quantitative synthesis. Clinical Trial: The protocol was registered in the International Prospective Register of Systemic Reviews (PROSPERO): registration no. CRD42022308806; available at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=308806.
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