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Molfenter T, Roget N, Chaple M, Behlman S, Cody O, Hartzler B, Johnson E, Nichols M, Stilen P, Becker S. Use of Telehealth in Substance Use Disorder Services During and After COVID-19: Online Survey Study. JMIR Ment Health 2021; 8:e25835. [PMID: 33481760 PMCID: PMC7895293 DOI: 10.2196/25835] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/01/2020] [Accepted: 01/19/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Social distancing guidelines for COVID-19 have caused a rapid transition to telephone and video technologies for delivering treatment for substance use disorders (SUDs). OBJECTIVE This study examined the adoption of these technologies across the SUD service continuum, acceptance of these technologies among service providers, and intent of providers to use these technologies after the pandemic. Additional analysis using the validated technology acceptance model (TAM) was performed to test the potential applications of these technologies after the pandemic. The study objectives were as follows: (1) to assess the use of telehealth (telephone and video technologies) for different SUD services during COVID-19 in May-June 2020, (2) to assess the intended applications of telehealth for SUD services beyond COVID-19, (3) to evaluate the perceived ease of use and value of telehealth for delivering SUD services, and (4) to assess organizational readiness for the sustained use of telehealth services. METHODS An online survey on the use of telephonic and video services was distributed between May and August 2020 to measure the current use of these services, perceived organizational readiness to use these services, and the intent to use these services after COVID-19. In total, 8 of 10 regional Addiction Technology Transfer Centers representing 43 states distributed the survey. Individual organizations were the unit of analysis. RESULTS In total, 457 organizations responded to the survey. Overall, the technology was widely used; >70% (n>335) of organizations reported using telephone or video platforms for most services. The odds of the intent of organizations to use these technologies to deliver services post COVID-19 were significantly greater for all but two services (ie, telephonic residential counseling and buprenorphine therapy; mean odds ratio 3.79, range 1.87-6.98). Clinical users preferred video technologies to telephone technologies for virtually all services. Readiness to use telephone and video technologies was high across numerous factors, though telephonic services were considered more accessible. Consistent with the TAM, perceived usefulness and ease of use influenced the intent to use both telephone and video technologies. CONCLUSIONS The overall perceived ease of use and usefulness of telephonic and video services suggest promising post-COVID-19 applications of these services. Survey participants consistently preferred video services to telephonic services; however, the availability of telephonic services to those lacking easy access to video technology is an important characteristic of these services. Future studies should review the acceptance of telehealth services and their comparative impact on SUD care outcomes.
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Affiliation(s)
- Todd Molfenter
- Center for Health Enhancement System Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Nancy Roget
- Center for the Application of Substance Abuse Technologies, University of Nevada-Reno, Reno, NV, United States
| | - Michael Chaple
- New York State Psychiatric Institute, Division on Substance Use Disorders, Columbia University Irving Medical Center, New York, NY, United States
| | - Stephanie Behlman
- Center for Health Enhancement System Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Olivia Cody
- Center for Health Enhancement System Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Bryan Hartzler
- Alcohol & Drug Abuse Institute, University of Washington, Seattle, WA, United States
| | - Edward Johnson
- National Center for Primary Care, Morehouse School of Medicine, Atlanta, GA, United States
| | - Maureen Nichols
- Addiction Research Institute, Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, United States
| | - Patricia Stilen
- School of Nursing and Health Studies, University of Missouri, Kansas City, MO, United States
| | - Sara Becker
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, United States
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Hamatani S, Tsuchiyagaito A, Nihei M, Hayashi Y, Yoshida T, Takahashi J, Okawa S, Arai H, Nagaoka M, Matsumoto K, Shimizu E, Hirano Y. Predictors of response to exposure and response prevention-based cognitive behavioral therapy for obsessive-compulsive disorder. BMC Psychiatry 2020; 20:433. [PMID: 32887553 PMCID: PMC7473813 DOI: 10.1186/s12888-020-02841-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 08/27/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Cognitive behavioral therapy (CBT), which includes exposure and response prevention (ERP), is effective in improving symptoms of obsessive-compulsive disorder (OCD). However, whether poor cognitive functions and autism spectrum disorder (ASD) traits affect the therapeutic response of patients with OCD to ERP-based CBT remains unclear. This study aimed to identify factors predictive of the therapeutic response of Japanese patients with OCD to ERP-based CBT. METHODS Forty-two Japanese outpatients with OCD were assessed using the Wechsler Adult Intelligence Scale-III (WAIS-III), Yale-Brown Obsessive-Compulsive Scale, Patient Health Questionnaire 9-item scale, and Autism Spectrum Quotient (AQ) at pre- and post-treatment. We used multiple regression analyses to estimate the effect on therapeutic response change. The treatment response change was set as a dependent variable in multiple regression analyses. RESULTS Multiple regression analyses showed that among independent variables, communication as an AQ sub-scale and Letter Number Sequencing as a WAIS-III sub-test predict the therapeutic response to ERP-based CBT . CONCLUSIONS Our results suggest that diminished working memory (Letter Number Sequencing), poor communication skill (AQ sub-scale) may undermine responsiveness to ERP-based CBT among patients with OCD. TRIAL REGISTRATION UMIN, UMIN00024087 . Registered 20 September 2016 - Retrospectively registered (including retrospective data).
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Affiliation(s)
- Sayo Hamatani
- Research Center for Child Mental Development, Chiba University, Inohana, Chuo-ku, Chiba, 2608670, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Aki Tsuchiyagaito
- Research Center for Child Mental Development, Chiba University, Inohana, Chuo-ku, Chiba, 2608670, Japan
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Masato Nihei
- Research Center for Child Mental Development, Chiba University, Inohana, Chuo-ku, Chiba, 2608670, Japan
| | - Yuta Hayashi
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Graduate School of Medicine and Veterinary Medicine, University of Miyazaki, Miyazaki, Japan
| | - Tokiko Yoshida
- Research Center for Child Mental Development, Chiba University, Inohana, Chuo-ku, Chiba, 2608670, Japan
| | - Jumpei Takahashi
- Research Center for Child Mental Development, Chiba University, Inohana, Chuo-ku, Chiba, 2608670, Japan
| | - Sho Okawa
- Graduate School of Medicine and Veterinary Medicine, University of Miyazaki, Miyazaki, Japan
- United Graduate School of Child Development, Osaka University Research Center of Child Mental Development, Chiba University, Chiba, Japan
| | - Honami Arai
- Research Center for Child Mental Development, Chiba University, Inohana, Chuo-ku, Chiba, 2608670, Japan
| | - Maki Nagaoka
- Research Center for Child Mental Development, Chiba University, Inohana, Chuo-ku, Chiba, 2608670, Japan
| | - Kazuki Matsumoto
- Research Center for Child Mental Development, Chiba University, Inohana, Chuo-ku, Chiba, 2608670, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Inohana, Chuo-ku, Chiba, 2608670, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Cognitive Behavioral Therapy Center, Chiba University Hospital, Chiba, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Inohana, Chuo-ku, Chiba, 2608670, Japan.
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Matsumoto K, Hamatani S, Makino T, Uemura T, Suzuki F, Shinno S, Ikai T, Hayashi H, Sutoh C, Shimizu E. Guided Internet-Based Cognitive Behavioral Therapy in Japanese Patients With Obsessive-Compulsive Disorder: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e18216. [PMID: 32442142 PMCID: PMC7381023 DOI: 10.2196/18216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Cognitive behavioral therapy for obsessive-compulsive disorder has been established, but access to this therapy in Japan is limited. Internet-based cognitive behavioral therapy may improve treatment accessibility and sufficiently improve obsessive-compulsive symptoms. There are few randomized controlled trials examining the effectiveness of internet-based cognitive behavioral therapy in patients with obsessive-compulsive disorder. We designed a randomized controlled trial protocol to assess the effectiveness of guided internet-based cognitive behavioral therapy in Japanese patients with obsessive-compulsive disorder. OBJECTIVE We aimed to develop a protocol for a randomized controlled trial of internet-based cognitive behavioral therapy in Japanese patients with obsessive-compulsive disorder. METHODS The randomized controlled trial will compare internet-based cognitive behavioral therapy treatment and usual care groups, each consisting of 15 participants (n=30) diagnosed with obsessive-compulsive disorder. We will evaluate the effectiveness of a 12-week intervention. The primary outcome of symptom severity will be measured using the Yale-Brown Obsessive-Compulsive Scale. Secondary outcomes will be assessed with the Obsessive-Compulsive Inventory, Beck Anxiety Inventory, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Working Alliance Inventory-Short Form, and the Euro Qol - 5 Dimension. All measures will be assessed at weeks 0 (baseline) and 12 (follow-up). In the statistical analysis comparing treatment effects, the least-squares means and their 95% CIs will be estimated by analysis of covariance with the change in total outcomes scores at week 12. All comparisons are planned, and all P values will be two-sided, with values <.05 considered statistically significant. RESULTS The study will be performed from January 2020 to March 2021, and results are expected to be available in mid-2021. CONCLUSIONS The trial will demonstrate whether internet-based cognitive behavioral therapy improves access and is more effective than more usual care for patients with obsessive-compulsive disorder in Japan. TRIAL REGISTRATION University Hospital Medical Information Network (UMIN) 000039375; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000044422. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/18216.
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Affiliation(s)
- Kazuki Matsumoto
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Sayo Hamatani
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Takuya Makino
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
| | - Taku Uemura
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Futoshi Suzuki
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
| | - Seina Shinno
- Department of Integrated Medical Sciences, Graduate School of Medicine, University of Fukui, Fukui, Japan
- Department of Integrated Advanced Medicine, Graduate School of Medicine, University of Fukui, Fukui, Japan
| | - Tomoki Ikai
- Department of Primary Health Care, Faculty of Medicine, University of Fukui, Fukui, Japan
| | - Hiroyuki Hayashi
- Department of Integrated Advanced Medicine, Graduate School of Medicine, University of Fukui, Fukui, Japan
- Department of Emaergency and General Medicine, University of Fukui Hospital, Fukui, Japan
| | - Chihiro Sutoh
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
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