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Siste K, Ophinni Y, Hanafi E, Yamada C, Novalino R, Limawan AP, Beatrice E, Rafelia V, Alison P, Matsumoto T, Sakamoto R. Relapse Prevention Group Therapy in Indonesia Involving Peers via Videoconferencing for Substance Use Disorder: Development and Feasibility Study. JMIR Form Res 2024; 8:e50452. [PMID: 38888959 PMCID: PMC11220436 DOI: 10.2196/50452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 03/30/2024] [Accepted: 04/24/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Substance use disorder (SUD) is a major health issue in Indonesia, where several barriers to treatment exist, including inaccessibility to treatment services, stigma, and criminalization of drug issues. Peer involvement and the use of telemedicine to deliver psychotherapy are promising approaches to overcome these barriers. OBJECTIVE This study aims (1) to describe the development of a new group psychotherapy coprovided by a health care worker and a peer and (2) to evaluate the acceptability, practicality, and preliminary outcomes of the program delivered via videoconferencing in Indonesia. METHODS Building upon an established relapse prevention therapy in Japan, we developed a 3-month weekly group therapy module in the Indonesian language. Adjustments were made via focus group discussions with local stakeholders in terms of substance types, understandability, inclusive language, and cultural relevance. A pilot study was conducted to test the new module provided by a peer and a psychiatrist via videoconferencing, termed tele-Indonesia Drug Addiction Relapse Prevention Program (tele-Indo-DARPP), with a pre- and postcontrolled design. We analyzed data from semistructured feedback interviews and outcome measurements, including the number of days using substances and quality of life, and compared the intervention (tele-Indo-DARPP added to treatment as usual [TAU]) and control (TAU only) arms. RESULTS In total, 8 people diagnosed with SUD participated in the pilot study with a mean age of 37 (SD 12.8) years. All were men, and 7 (88%) used sedatives as the primary substance. Collectively, they attended 44 of the 48 tele-Indo-DARPP sessions. A total of 3 out of 4 (75%) preferred telemedicine rather than in-person therapy. Positive acceptability and practicality were shown from qualitative feedback, in which the participants who joined the tele-Indo-DARPP reported that they liked the convenience of joining from home and that they were able to open up about personal matters, received helpful advice from peers, and received support from other participants. Providers reported that they feel the module was provider-friendly, and the session was convenient to join without diminishing rapport-building. Meanwhile, troubles with the internet connection and difficulty in comprehending some terminology in the workbook were reported. The intervention arm showed better improvements in psychological health and anxiety symptoms. CONCLUSIONS Group psychotherapy via videoconferencing coprovided by health care workers and peers was acceptable and practical for participants with SUD and service providers in this study. A large-scale study is warranted to examine the effectiveness of the newly developed module in Indonesia.
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Affiliation(s)
- Kristiana Siste
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Youdiil Ophinni
- The Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan
- Department of Environmental Coexistence, Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
- Ragon Institute of Mass General, MIT, and Harvard, Cambridge, MA, United States
| | - Enjeline Hanafi
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Chika Yamada
- Department of Environmental Coexistence, Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | - Albert P Limawan
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Evania Beatrice
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Vania Rafelia
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Peter Alison
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ryota Sakamoto
- Department of Environmental Coexistence, Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
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Kuroda N, Tamiya N. Excess mortality among adults with mental disorders treated in psychiatric and general medical settings: A population-based cohort study using municipal medical claims data in Japan. Asian J Psychiatr 2023; 88:103719. [PMID: 37567083 DOI: 10.1016/j.ajp.2023.103719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/26/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVES To estimate the excess mortality associated with serious mental illnesses (schizophrenia and bipolar disorder) and common mental disorders (depression and anxiety) at the population level. METHODS We conducted a population-based, retrospective cohort study in Tsukuba, Japan. Individuals aged 20-74 years and insured for at least 12 months by the National Health Insurance or Late Elders' Health Insurance as of April 2015 were included (n = 41,618, 29% of the city's population aged 20-74 years). Individuals with mental disorders (International Classification of Diseases-10 code: F00-F99) were identified in psychiatric and general medical services using medical claims during the 12-month baseline period and classified into mutually exclusive diagnostic subgroups. Their age/sex-adjusted all-cause mortality rate ratios (aMRRs) were estimated and compared to those of individuals without mental disorders. RESULTS Altogether, 12.0% of participants had mental disorders (general medical service: 7.2% vs. psychiatric service: 4.8%). Common mental disorders were the most prevalent (8.1%). During the median 48 months of observation, 225 deaths were observed in people with mental disorders. The aMRR was 1.98 (95%CI: 1.70-2.29) for all mental disorders, with a higher rate ratio in psychiatric service than in general medical service users (aMRR: 2.64 [2.12-3.29] vs. 1.70 [1.42-2.04]), 3.57 (2.71-4.70) for serious mental illness, with a higher rate ratio in psychiatric inpatient service than in outpatient service users (aMRR: 5.74 [3.76-8.78] vs. 2.84 [2.00-4.04]), and 1.53 (1.27-1.84) for common mental disorders. CONCLUSION Serious and common mental disorders in psychiatric and general health services are associated with increased mortality in Japan.
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Affiliation(s)
- Naoaki Kuroda
- Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba, Ibaraki 305-8575, Japan; Health Department, Tsukuba City, 1-1-1 Kenkyu-Gakuen, Tsukuba, Ibaraki 305-0817, Japan; Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan.
| | - Nanako Tamiya
- Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba, Ibaraki 305-8575, Japan; Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba, Ibaraki 305-8575, Japan
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Kählke F, Buntrock C, Smit F, Ebert DD. Systematic review of economic evaluations for internet- and mobile-based interventions for mental health problems. NPJ Digit Med 2022; 5:175. [PMID: 36424463 PMCID: PMC9686241 DOI: 10.1038/s41746-022-00702-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 10/03/2022] [Indexed: 11/27/2022] Open
Abstract
In view of the staggering disease and economic burden of mental disorders, internet and mobile-based interventions (IMIs) targeting mental disorders have often been touted to be cost-effective; however, available evidence is inconclusive and outdated. This review aimed to provide an overview of the cost-effectiveness of IMIs for mental disorders and symptoms. A systematic search was conducted for trial-based economic evaluations published before 10th May 2021. Electronic databases (including MEDLINE, PsycINFO, CENTRAL, PSYNDEX, and NHS Economic Evaluations Database) were searched for randomized controlled trials examining IMIs targeting mental disorders and symptoms and conducting a full health economic evaluation. Methodological quality and risk of bias were assessed. Cost-effectiveness was assumed at or below £30,000 per quality-adjusted life year gained. Of the 4044 studies, 36 economic evaluations were reviewed. Guided IMIs were likely to be cost-effective in depression and anxiety. The quality of most evaluations was good, albeit with some risks of bias. Heterogeneity across studies was high because of factors such as different costing methods, design, comparison groups, and outcomes used. IMIs for anxiety and depression have potential to be cost-effective. However, more research is needed into unguided (preventive) IMIs with active control conditions (e.g., treatment as usual) and longer time horizon across a wider range of disorders.Trial registration: PROSPERO Registration No. CRD42018093808.
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Affiliation(s)
- Fanny Kählke
- grid.6936.a0000000123222966Department of Sport and Health Sciences, Professorship of Psychology and Digital Mental Health Care, Technische Universität München, Munich, Germany
| | - Claudia Buntrock
- grid.5807.a0000 0001 1018 4307Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto-von-Guericke-University, Magdeburg, Germany
| | - Filip Smit
- grid.12380.380000 0004 1754 9227Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands ,grid.509540.d0000 0004 6880 3010Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands ,grid.416017.50000 0001 0835 8259Centre of Health-Economic Evaluation, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - David Daniel Ebert
- grid.6936.a0000000123222966Department of Sport and Health Sciences, Professorship of Psychology and Digital Mental Health Care, Technische Universität München, Munich, Germany
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Takano A, Miyamoto Y, Shinozaki T, Matsumoto T, Kawakami N. Effects of a web‐based relapse prevention program on abstinence: Secondary subgroup analysis of a pilot randomized controlled trial. Neuropsychopharmacol Rep 2022; 42:362-367. [PMID: 35689457 PMCID: PMC9515705 DOI: 10.1002/npr2.12272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 12/01/2022] Open
Abstract
Aim The effect of a web‐based relapse prevention program might vary depending on a specific population if the study participants included drug users with various characteristics. This secondary analysis explored subgroups among Japanese drug users that may benefit from a web‐based relapse prevention program. Methods Outpatients with drug use disorder (n = 48) were randomly assigned to an 8‐week, six‐session web‐based relapse prevention program (intervention group) or web‐based self‐monitoring only (control group). We tested the effects of the intervention on abstinence in different subgroups divided by a primary abused drug (methamphetamine vs other drugs), previous face‐to‐face relapse prevention (received vs not received), and outpatient treatment term (long‐term: ≥3 years vs short‐term: <3 years). Consecutive abstinence duration from the primary abused drug was compared in the subgroups, and the interaction between the intervention condition and the subgroup condition was assessed. Results In the subgroup with short‐term outpatient treatment, the intervention group maintained better abstinence than the control group. For those who used methamphetamine or those who had previously received a face‐to‐face relapse prevention program, the intervention group showed larger effect sizes than the results from all the participants. However, the interaction between the intervention condition and the subgroup condition was not significant for any subgroup. Conclusions This study suggests that patients with short‐term treatment may benefit from a web‐based relapse prevention program as an alternative treatment. We need to recruit and allocate patients considering their treatment term in a future definitive trial.
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Affiliation(s)
- Ayumi Takano
- Department of Mental Health and Psychiatric Nursing Tokyo Medical and Dental University Tokyo Japan
| | - Yuki Miyamoto
- Department of Psychiatric Nursing The University of Tokyo Tokyo Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering Tokyo University of Science Tokyo Japan
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research National Center of Neurology and Psychiatry Tokyo Japan
| | - Norito Kawakami
- Department of Mental Health The University of Tokyo Tokyo Japan
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Sangrà PS, Ribeiro TC, Esteban-Sepúlveda S, Pagès EG, Barbeito BL, Llobet JA, Moya-Prats JLP, Pérez LP, Mir SA. Mental health assessment of Spanish frontline healthcare workers during the SARS-CoV-2 pandemic. MEDICINA CLÍNICA (ENGLISH EDITION) 2022; 159:268-277. [PMID: 36157839 PMCID: PMC9483750 DOI: 10.1016/j.medcle.2021.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/12/2021] [Indexed: 11/24/2022]
Abstract
Background and objective The Covid-19 pandemic continues challenging health systems globally, exposing healthcare workers to constant physical and psychological stressors. To date, several studies have already shown the catastrophic impact on the mental health of medical personnel during the early period of the pandemic. Nevertheless, literature evidences the dearth of works that evaluate the effect over time, understanding the pandemic as a sustained extreme stressor. The present study examines the effect of the pandemic on the mental health of Covid-19 frontline healthcare workers at six months follow-up. Material and methods A total of 141 frontline healthcare workers from two tertiary hospitals were recruited between July and November 2020. Healthcare workers were evaluated psychologically at baseline and six months follow-up (January to May 2021) using psychometric tests for the assessment of acute stress (VASS, PSS-10, PCL-5), anxiety (STAI) and depression (PHQ-2) Results Overall, there was a general worsening of the mental health between the two psychological assessments, especially regarding depression and predisposition to perceiving the situations as a threat. Nurses and nurse aides showed poorer mental health while physicians improved over time. Reduced working hours and higher physical exercise resulted in better mental health among healthcare workers. Women and nursing staff were the most affected by psychological distress at baseline and six months follow-up. Conclusion Reduced working hours, adequate resting periods, physical exercise, and efficient intervention strategies are of utmost importance in preventing, controlling, and reducing psychological distress among healthcare workers when coping with critical scenarios such as the current pandemic.
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Quero S, Palau-Batet M, Tur C, Mor S, Campos D, Rachyla I, Grimaldos J, Marco JH. Effect of an internet-based intervention for adjustment disorder on meaning in life and enjoyment. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03177-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Abstract
Introduction
Positive psychological variables, such as meaning in life and the capacity for enjoyment, are important resilience factors against negative behaviors and symptoms. These constructs are related to better emotional regulation strategies, a greater perception of control over one’s life, and better mental health in general. Adjustment disorder (AjD) is a prevalent condition defined as the failure to adapt to a stressful event.
Objective
This study presents secondary analysis data on the effect of an Internet-delivered cognitive-behavioral therapy intervention (iCBT) for AjD on meaning in life and capacity for enjoyment, compared to a control group.
Method
The sample consisted of 68 participants with AjD. 34 in the iCBT condition and 34 in the control group). Meaning in life was assessed by the Purpose-in-Life Test-10, and the Environmental Rewards Observation Scale was used to assess the capacity for enjoyment. The iCBT intervention focused on acceptance and processing of the stressful event. Intent-to-treat mixed-model analyses without any ad hoc imputations and using Cohen’s d effect comparisons were conducted.
Results
The results revealed a significant main effect of time and a significant group x time interaction in all the measures. Significantly higher pre-post score differences were found in the treatment condition.
Discussion
Meaning in life and capacity for enjoyment can change after an iCBT intervention for AjD. Therapeutic implications of the results and future lines of research about the role of meaning in life in AjD are discussed.
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Göçmen A, Derin N, Metin A, Kariper IA. PROJECT STAR (Midwestern Prevention Project): Overview. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:1361-1375. [PMID: 34599833 DOI: 10.1002/jcop.22720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Abstract
The program designed to prevent substance use should be planned in multiple dimensions. One of these programs is Project Star. This study aims to evaluate the studies on the Project Star and identify the strengths and weaknesses of the program. For this purpose, the keywords "Project Star" and "Midwestern Prevention Project" were scanned from databases. The results of these studies were evaluated by giving a summary of the studies included in the study. As a result, the strengths of Project Star are that it is multidimensional, focuses on early development periods, includes the individual's ecological environment, and reduces substance use in later development periods, and not having an internet-based version. This situation has been identified as its weaknesses since its situation in other societies is unknown due to its cost and limited international applications.
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Affiliation(s)
- Aliye Göçmen
- Department of Science Education, Education Faculty, Erciyes University, Kayseri, Turkey
| | - Nur Derin
- Department of Science Education, Education Faculty, Erciyes University, Kayseri, Turkey
| | - Ahmet Metin
- Department of Science Education, Education Faculty, Erciyes University, Kayseri, Turkey
| | - I Afşin Kariper
- Department of Science Education, Education Faculty, Erciyes University, Kayseri, Turkey
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Sobregrau Sangrà P, Aguiló Mir S, Castro Ribeiro T, Esteban-Sepúlveda S, García Pagès E, López Barbeito B, Pomar Moya-Prats JL, Pintor Pérez L, Aguiló Llobet J. Mental health assessment of Spanish healthcare workers during the SARS-CoV-2 pandemic. A cross-sectional study. Compr Psychiatry 2022; 112:152278. [PMID: 34678607 PMCID: PMC8501183 DOI: 10.1016/j.comppsych.2021.152278] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/13/2021] [Accepted: 09/21/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The SARS-CoV-2 outbreak is posing unprecedented care scenarios, increasing the psychological distress among healthcare workers while reducing the efficiency of health systems. This work evaluated the psychological impact of the Covid-19 pandemic on Spanish frontline healthcare workers of two tertiary hospitals. MATERIAL AND METHODS Healthcare workers were recruited from the medical units designated for the care of Covid-19 patients. The psychological assessment consisted of an individual, face-to-face session where gold-standard psychometric tests were administered to assess stress (VASS & PSS-10), anxiety (STAI), depression (PHQ-2) and posttraumatic stress disorder (PCL-5). Regression models were also fitted to identify predictors of psychological distress. RESULTS Overall, almost 13% of healthcare workers showed severe anxiety, while more than 26% had high levels of perceived stress. More than 23% presented severe posttraumatic stress symptoms, and another 13% had PHQ-2 scores equal to or above 3, compatible with Major Depressive Disorder (MDD) diagnosis, respectively. Women, stress-related medication, overworking, performing in Covid-19 wards, and substance abuse were risk factors for increased psychological distress. Instead, practising exercise reduced the burden. CONCLUSION This study outlines the severe psychological impact of the Covid-19 pandemic on Spanish frontline healthcare workers. The stress, depression and anxiety levels found were similar to those reported in similar works but much higher than in Wuhan healthcare workers. Knowledge of risk factors for increased psychological distress may help to develop comprehensive intervention strategies to prevent, control and reduce the mental health exacerbation of healthcare workers, thereby maintaining the effectiveness of health systems in critical scenarios.
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Affiliation(s)
- Pau Sobregrau Sangrà
- Emergency Department, Hospital Clinic of Barcelona, Barcelona, 08036, Spain; Psychiatry Department, Hospital Clinic of Barcelona, Barcelona 08036, Spain.
| | - Sira Aguiló Mir
- Emergency Department, Hospital Clinic of Barcelona, Barcelona, 08036, Spain
| | - Thaís Castro Ribeiro
- Networking Biomedical Research Center: Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Autònoma de Barcelona (UAB), Bellaterra 08193, Spain
| | - Silvia Esteban-Sepúlveda
- Research Group in Nursing Care (GRECI), Hospital del Mar Institute of Medical Research (IMIM), Barcelona 08003, Spain,Consorci Parc de Salut MAR de Barcelona, Hospital del Mar of Barcelona, Barcelona 08003, Spain
| | - Esther García Pagès
- Networking Biomedical Research Center: Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Autònoma de Barcelona (UAB), Bellaterra 08193, Spain
| | | | | | - Luís Pintor Pérez
- Psychiatry Department, Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Jordi Aguiló Llobet
- Microelectronics and Electronic Systems Department, Universitat Autònoma de Barcelona (UAB), Bellaterra 08193, Spain
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Sangrà PS, Ribeiro TC, Esteban-Sepúlveda S, Pagès EG, Barbeito BL, Llobet JA, Moya-Prats JLP, Pérez LP, Mir SA. Mental health assessment of Spanish frontline healthcare workers during the SARS-CoV-2 pandemic. Med Clin (Barc) 2021; 159:268-277. [PMID: 34974883 PMCID: PMC8677467 DOI: 10.1016/j.medcli.2021.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 01/03/2023]
Abstract
Background and objective The Covid-19 pandemic continues challenging health systems globally, exposing healthcare workers to constant physical and psychological stressors. To date, several studies have already shown the catastrophic impact on the mental health of medical personnel during the early period of the pandemic. Nevertheless, literature evidences the dearth of works that evaluate the effect over time, understanding the pandemic as a sustained extreme stressor. The present study examines the effect of the pandemic on the mental health of Covid-19 frontline healthcare workers at six months follow-up. Material and methods A total of 141 frontline healthcare workers from two tertiary hospitals were recruited between July and November 2020. Healthcare workers were evaluated psychologically at baseline and six months follow-up (January to May 2021) using psychometric tests for the assessment of acute stress (VASS, PSS-10, PCL-5), anxiety (STAI) and depression (PHQ-2) Results Overall, there was a general worsening of the mental health between the two psychological assessments, especially regarding depression and predisposition to perceiving the situations as a threat. Nurses and nurse aides showed poorer mental health while physicians improved over time. Reduced working hours and higher physical exercise resulted in better mental health among healthcare workers. Women and nursing staff were the most affected by psychological distress at baseline and six months follow-up. Conclusion Reduced working hours, adequate resting periods, physical exercise, and efficient intervention strategies are of utmost importance in preventing, controlling, and reducing psychological distress among healthcare workers when coping with critical scenarios such as the current pandemic.
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Affiliation(s)
- Pau Sobregrau Sangrà
- Emergency Department, Hospital Clinic of Barcelona, Barcelona 08036, Spain; Faculty of Psychology, University of Barcelona (UB), Barcelona 080035, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clinic of Barcelona, Barcelona 08036, Spain.
| | - Thaís Castro Ribeiro
- Psychiatry Department, Hospital Clinic of Barcelona, Barcelona 08036, Spain; Networking Biomedical Research Center: Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Autònoma de Barcelona (UAB), Bellaterra 08193, Spain
| | - Silvia Esteban-Sepúlveda
- Research Group in Nursing Care (GRECI), Hospital del Mar Institute of Medical Research (IMIM), Barcelona 08003, Spain; Consorci Parc de Salut MAR de Barcelona, Hospital del Mar of Barcelona, Barcelona 08003, Spain
| | - Esther García Pagès
- Networking Biomedical Research Center: Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Autònoma de Barcelona (UAB), Bellaterra 08193, Spain
| | | | - Jordi Aguiló Llobet
- Microelectronics and Electronic Systems Department, Universitat Autònoma de Barcelona (UAB), Bellaterra 08193, Spain
| | | | - Luís Pintor Pérez
- Faculty of Psychology, University of Barcelona (UB), Barcelona 080035, Spain; Clinical Institute of Neurosciences (ICN), Hospital Clinic of Barcelona, Barcelona 08036, Spain; Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clinic of Barcelona, Barcelona 08036, Spain
| | - Sira Aguiló Mir
- Emergency Department, Hospital Clinic of Barcelona, Barcelona 08036, Spain
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Xu X, Chen S, Chen J, Chen Z, Fu L, Song D, Zhao M, Jiang H. Feasibility and Preliminary Efficacy of a Community-Based Addiction Rehabilitation Electronic System in Substance Use Disorder: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e21087. [PMID: 33861211 PMCID: PMC8087963 DOI: 10.2196/21087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/03/2020] [Accepted: 03/22/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Drug use disorder has high potential for relapse and imposes an enormous burden on public health in China. Since the promulgation of the Anti-drug law in 2008, community-based rehabilitation has become the primary approach to treat drug addiction. However, multiple problems occurred in the implementation process, leading to a 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 assigned social workers. OBJECTIVE The study aimed to examine the feasibility and preliminary efficacy of CAREs in community-based rehabilitation from the perspective of drug users and social workers 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 the control group (n=20) received community-based rehabilitation only for 6 months. CAREs provided education, assessment, and SOS (support) functions for drug users. The assigned social workers provided service and monitored drug use behavior as usual except that the social workers in the intervention group could access the webpage end to obtain drug users' information and fit their routine workflow into CAREs. The primary outcome was the feasibility of CAREs, 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 to the 6-month follow-up. RESULTS The number of participants logged in to the app ranged from 7 to 20 per week, and CAREs had relatively high levels of continued patient use. Drug users preferred assessment and education features in the app end while their social workers showed high levels of use in urine results record and viewing assessment results on the webpage end. After the 6-month intervention, 3.3% (17/520) of samples in the intervention group and 7.5% (39/520) in the control group were drug-positive (F=4.358, P=.04). No significant differences were noted between the control and intervention groups in terms of longest duration of abstinence, number of 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. TRIAL REGISTRATION ClinicalTrials.gov NCT03451344; https://clinicaltrials.gov/ct2/show/NCT03451344. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.3389/fpsyt.2018.00556.
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Affiliation(s)
- Xiaomin Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shujuan Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junning Chen
- Nantong Winner Information Technology Co Ltd, Nantong, China
| | - Zhikang Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liming Fu
- Council of Shanghai Ziqiang Social Services, Shanghai, China
| | - Dingchen Song
- Council of Shanghai Zhongzhi Social Services, Shanghai, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.,Shanghai Clinical Research Center for Mental Health, Shanghai, China.,Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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11
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Takano A, Matsumoto T. A Mixed-Methods Evaluation of Usability and Acceptability of Web-Based Relapse Prevention and Self-Monitoring Program: Secondary Analysis of a Pilot Randomized Controlled Trial. Front Psychiatry 2021; 12:625480. [PMID: 33643096 PMCID: PMC7905227 DOI: 10.3389/fpsyt.2021.625480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/19/2021] [Indexed: 11/13/2022] Open
Abstract
This secondary analysis of a pilot randomized controlled trial assessed the usability and acceptability of a web-based relapse prevention and self-monitoring program, which was newly developed for Japanese drug users. We analyzed quantitative and qualitative data using a mixed-method approach among 43 study participants. We assessed the usability of the programs using the Web Usability Scale (WUS) and satisfaction and acceptance using the Client Satisfaction Questionnaire 8-item version (CSQ-8). We also collected qualitative feedback using semi-structured open-ended questions. The results of WUS indicated that the usability of the programs was sufficient. According to the CSQ-8 results, the self-monitoring program had less satisfaction, while the web-based relapse prevention program met satisfaction. Some possible improvements for a future version of the web-based programs were suggested based on participants' feedback.
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Affiliation(s)
- Ayumi Takano
- Department of Mental Health and Psychiatric Nursing, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research, National Center of Neurology and Psychiatry, Tokyo, Japan
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12
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Zhao Q, Mao Y, Li X, Zheng Y. Drug use characteristics and correlates of multiple risk behaviors among synthetic drug users. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1846804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Qun Zhao
- Research Institute for Environment and Health, School of Law and Public Affairs, Nanjing University of Information Science and Technology, Nanjing, Jiangsu, China
| | - Yuchen Mao
- Department of Statistics, University of South Carolina, Columbia, South Carolina, USA
| | - Xiaoming Li
- Research Institute for Environment and Health, School of Law and Public Affairs, Nanjing University of Information Science and Technology, Nanjing, Jiangsu, China
- South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina Arnold School of Public Health, Columbia, South Carolina, USA
| | - Yu Zheng
- Center for Global Health, Nanjing Medical University, Nanjing, Jiangsu, China
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13
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Effect of a web-based relapse prevention program on abstinence among Japanese drug users: A pilot randomized controlled trial. J Subst Abuse Treat 2020; 111:37-46. [DOI: 10.1016/j.jsat.2019.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/08/2019] [Accepted: 12/03/2019] [Indexed: 12/22/2022]
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14
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Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis. Epidemiol Psychiatr Sci 2019; 28:376-388. [PMID: 30739625 PMCID: PMC6669989 DOI: 10.1017/s2045796019000027] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
UNLABELLED AimsIn the past few years, there has been an unprecedented increase in the number of forcibly displaced migrants worldwide, of which a substantial proportion is refugees and asylum seekers. Refugees and asylum seekers may experience high levels of psychological distress, and show high rates of mental health conditions. It is therefore timely and particularly relevant to assess whether current evidence supports the provision of psychosocial interventions for this population. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing the efficacy and acceptability of psychosocial interventions compared with control conditions (treatment as usual/no treatment, waiting list, psychological placebo) aimed at reducing mental health problems in distressed refugees and asylum seekers. METHODS We used Cochrane procedures for conducting a systematic review and meta-analysis of RCTs. We searched for published and unpublished RCTs assessing the efficacy and acceptability of psychosocial interventions in adults and children asylum seekers and refugees with psychological distress. Post-traumatic stress disorder (PTSD), depressive and anxiety symptoms at post-intervention were the primary outcomes. Secondary outcomes include: PTSD, depressive and anxiety symptoms at follow-up, functioning, quality of life and dropouts due to any reason. RESULTS We included 26 studies with 1959 participants. Meta-analysis of RCTs revealed that psychosocial interventions have a clinically significant beneficial effect on PTSD (standardised mean difference [SMD] = -0.71; 95% confidence interval [CI] -1.01 to -0.41; I2 = 83%; 95% CI 78-88; 20 studies, 1370 participants; moderate quality evidence), depression (SMD = -1.02; 95% CI -1.52 to -0.51; I2 = 89%; 95% CI 82-93; 12 studies, 844 participants; moderate quality evidence) and anxiety outcomes (SMD = -1.05; 95% CI -1.55 to -0.56; I2 = 87%; 95% CI 79-92; 11 studies, 815 participants; moderate quality evidence). This beneficial effect was maintained at 1 month or longer follow-up, which is extremely important for populations exposed to ongoing post-migration stressors. For the other secondary outcomes, we identified a non-significant trend in favour of psychosocial interventions. Most evidence supported interventions based on cognitive behavioural therapies with a trauma-focused component. Limitations of this review include the limited number of studies collected, with a relatively low total number of participants, and the limited available data for positive outcomes like functioning and quality of life. CONCLUSIONS Considering the epidemiological relevance of psychological distress and mental health conditions in refugees and asylum seekers, and in view of the existing data on the effectiveness of psychosocial interventions, these interventions should be routinely made available as part of the health care of distressed refugees and asylum seekers. Evidence-based guidelines and implementation packages should be developed accordingly.
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15
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Chen IC, Teng G, Chen CJ, Lan TH, Liu HJ. The Autonomic Progress Bar Motivates Treatment Completion for Patients of Stimulant Use Disorder and Cannabis Use Disorder. Front Psychiatry 2019; 10:944. [PMID: 31998160 PMCID: PMC6970339 DOI: 10.3389/fpsyt.2019.00944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 11/29/2019] [Indexed: 12/03/2022] Open
Abstract
Background: The intrinsic motivation behind the "need to complete" is more influential than external incentives. We introduced a novel progress-bar tool to motivate the completion of programs designed to treat stimulant and cannabis use disorders. We further examined the effectiveness of the progress bar's scoring approach in forecasting consistently negative urine tests. Methods: This study's participants included 568 patients with stimulant, amphetamine-type, and cannabis use disorders who were undergoing 12-month mandatory treatment programs at Taichung Veterans General Hospital in Taiwan. Patients were given scores of 1, -1, or 0 depending on whether they received negative, positive, or missing urinalysis reports, respectively. The autonomic progress bar generated weekly score totals. At the group level, scorei donated scores from all patients for a given week (i denoted the week). Scorei was standardized to adjusted scorei. We then conducted Autoregressive Integrated Moving Average (ARIMA) Model of time-series analyses for the adjusted scorei. Results: A total of 312 patients maintained treatment progress over the 12-month program. The autonomic score calculator totaled the shared achievements of these patients. The coefficients of the lag variables for mean (p), lag variables for residual error term (q), and number of orders for ensuring stationary (d) were estimated at p = 3, d = 4, and q = 7 for the first half of the treatment program, and were estimated at p = 2, d = 2, and q = 3 for the second half. Both models were stationary and tested as fit for prediction (p < 0.05). Sharply raised adjusted scores were predicted during the high-demand treatment phase. Discussion: This study's novel progress-bar tool effectively motivated treatment completion. It was also effective in forecasting continually negative urine tests. The tool's free open-source code makes it easy to implement among many substance-treatment services.
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Affiliation(s)
- I-Chun Chen
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Gloria Teng
- Department of Mathematics, Xiamen University Malaysia, Selangor, Malaysia
| | - Chur-Jen Chen
- Department of Applied Mathematics, Tunghai University, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hung-Jen Liu
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan.,Institute of Molecular Biology, National Chung Hsing University, Taichung, Taiwan
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16
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Zhang MW, Ho RC. Moodle: The cost effective solution for internet cognitive behavioral therapy (I-CBT) interventions. Technol Health Care 2017; 25:163-165. [DOI: 10.3233/thc-161261] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Melvyn W.B. Zhang
- Biomedical Institute for Global Health Research and Technology, National University of Singapore, Singapore
- Biomedical Institute for Global Health Research and Technology, National University of Singapore, Singapore
| | - Roger C.M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Biomedical Institute for Global Health Research and Technology, National University of Singapore, Singapore
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17
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Tiburcio M, Lara MA, Aguilar Abrego A, Fernández M, Martínez Vélez N, Sánchez A. Web-Based Intervention to Reduce Substance Abuse and Depressive Symptoms in Mexico: Development and Usability Test. JMIR Ment Health 2016; 3:e47. [PMID: 27687965 PMCID: PMC5051776 DOI: 10.2196/mental.6001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/02/2016] [Accepted: 08/15/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The development of Web-based interventions for substance abuse in Latin America is a new field of interest with great potential for expansion to other Spanish-speaking countries. OBJECTIVE This paper describes a project aimed to develop and evaluate the usability of the Web-based Help Program for Drug Abuse and Depression (Programa de Ayuda para Abuso de Drogas y Depresión, PAADD, in Spanish) and also to construct a systematic frame of reference for the development of future Web-based programs. METHODS The PAADD aims to reduce substance use and depressive symptoms with cognitive behavioral techniques translated into Web applications, aided by the participation of a counselor to provide support and guidance. This Web-based intervention includes 4 steps: (1) My Starting Point, (2) Where Do I Want to Be? (3) Strategies for Change, and (4) Maintaining Change. The development of the program was an interactive multistage process. The first stage defined the core structure and contents, which were validated in stage 2 by a group of 8 experts in addiction treatment. Programming of the applications took place in stage 3, taking into account 3 types of end users: administrators, counselors, and substance users. Stage 4 consisted of functionality testing. In stage 5, a total of 9 health professionals and 20 drug users currently in treatment voluntarily interacted with the program in a usability test, providing feedback about adjustments needed to improve users' experience. RESULTS The main finding of stage 2 was the consensus of the health professionals about the cognitive behavioral strategies and techniques included in PAADD being appropriate for changing substance use behaviors. In stage 5, the health professionals found the functionalities easy to learn; their suggestions were related to the page layout, inclusion of confirmation messages at the end of activities, avoiding "read more" links, and providing feedback about every activity. On the other hand, the users said the information presented within the modules was easy to follow and suggested more dynamic features with concrete instructions and feedback. CONCLUSIONS The resulting Web-based program may have advantages over traditional face-to-face therapies owing to its low cost, wide accessibility, anonymity, and independence of time and distance factors. The detailed description of the process of designing a Web-based program is an important contribution to others interested in this field. The potential benefits must be verified in specific studies. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN): 25429892; http://www.controlled-trials.com/ISRCTN25429892 (Archived by WebCite at http://www.webcitation.org/6ko1Fsvym).
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Affiliation(s)
- Marcela Tiburcio
- Ramón de la Fuente Muñiz, National Institute of Psychiatry, Department of Social Sciences in Health, Direction of Epidemiological and Psychosocial Research, Mexico City, Mexico.
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Takano A, Miyamoto Y, Kawakami N, Matsumoto T, Shinozaki T, Sugimoto T. Web-based cognitive behavioral relapse prevention program with tailored feedback for people with methamphetamine and other drug use problems: protocol for a multicenter randomized controlled trial in Japan. BMC Psychiatry 2016; 16:87. [PMID: 27044304 PMCID: PMC4820974 DOI: 10.1186/s12888-016-0793-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 03/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the effectiveness of psychosocial programs for recovery from drug use problems, there have been challenges in implementation of treatment. Internet-based and computerized approaches have been known to be effective in treatment dissemination. The study purpose is to assess the effects of a web-based psychosocial relapse prevention program with a multicenter randomized controlled trial. METHODS Recruitment began in January 2015 for outpatient participants diagnosed with drug abuse or dependence who have used a primary abused drug in the past year at psychiatric hospitals and a clinic. Participants are randomized either to a web-based relapse prevention program or a self-monitoring group. The intervention is a web-based relapse prevention program named "e-SMARPP" that consists of six relapse prevention program modules with tailored feedback from health care professionals and 8 weeks of self-monitoring. The content is adapted from a face-to-face relapse prevention program which is based on cognitive behavioral therapy and motivational enhancement. The primary outcomes are relapse risk assessed by the Stimulant Relapse Risk Scale (baseline, 2-, 5- and 8-month) and the longest duration of consecutive abstinent days from primary abused drug during the intervention. Secondary outcomes will include motivation to change, self-efficacy for drug use and craving, abstinent days in the past 28 or 56 days, quality of life, sense of coherence, cost of substance use, medical cost, retention of treatment and use of self-help group. Completion, usability and satisfaction of the program will be also assessed to explore feasibility. This study protocol was approved by the Ethics Committee of The University of Tokyo and each recruiting hospital and clinic. DISCUSSION To our knowledge, this study is the first clinical trial to assess the effects of a web-based therapeutic program for drug users in Japan. If successful, this program is a promising approach for drug user treatment in Japan, where the stigma toward drug users is strong. The results are also useful for researchers who want to know about programs for various substances, including methamphetamine. TRIAL REGISTRATION This trial was registered with the University Hospital Medical Information Network clinical trial registry: UMIN000016075 (Date of registration: January 5, 2015).
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Affiliation(s)
- Ayumi Takano
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Yuki Miyamoto
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553 Japan
| | - Tomohiro Shinozaki
- Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Takashi Sugimoto
- Department of Health Technology Assessment and Public Policy, Graduate School of Public Policy, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
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