scholarly journals Technological Interventions for Medication Adherence in Adult Mental Health and Substance Use Disorders: A Systematic Review (Preprint)

2018 ◽  
Author(s):  
Jackson M Steinkamp ◽  
Nathaniel Goldblatt ◽  
Jacob T Borodovsky ◽  
Amy LaVertu ◽  
Ian M Kronish ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Substance Use ◽  
Medication Adherence ◽  
Mobile Phone ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Intervention Component ◽  
Taxonomic Framework ◽  
Multicomponent Interventions

BACKGROUND Medication adherence is critical to the effectiveness of psychopharmacologic therapy. Psychiatric disorders present special adherence considerations, notably an altered capacity for decision making and the increased street value of controlled substances. A wide range of interventions designed to improve adherence in mental health and substance use disorders have been studied; recently, many have incorporated information technology (eg, mobile phone apps, electronic pill dispensers, and telehealth). Many intervention components have been studied across different disorders. Furthermore, many interventions incorporate multiple components, making it difficult to evaluate the effect of individual components in isolation. OBJECTIVE The aim of this study was to conduct a systematic scoping review to develop a literature-driven, transdiagnostic taxonomic framework of technology-based medication adherence intervention and measurement components used in mental health and substance use disorders. METHODS This review was conducted based on a published protocol (PROSPERO: CRD42018067902) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review guidelines. We searched 7 electronic databases: MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, Web of Science, Engineering Village, and ClinicalTrials.gov from January 2000 to September 2018. Overall, 2 reviewers independently conducted title and abstract screens, full-text screens, and data extraction. We included all studies that evaluate populations or individuals with a mental health or substance use disorder and contain at least 1 technology-delivered component (eg, website, mobile phone app, biosensor, or algorithm) designed to improve medication adherence or the measurement thereof. Given the wide variety of studied interventions, populations, and outcomes, we did not conduct a risk of bias assessment or quantitative meta-analysis. We developed a taxonomic framework for intervention classification and applied it to multicomponent interventions across mental health disorders. RESULTS The initial search identified 21,749 results; after screening, 127 included studies remained (Cohen kappa: 0.8, 95% CI 0.72-0.87). Major intervention component categories include reminders, support messages, social support engagement, care team contact capabilities, data feedback, psychoeducation, adherence-based psychotherapy, remote care delivery, secure medication storage, and contingency management. Adherence measurement components include self-reports, remote direct visualization, fully automated computer vision algorithms, biosensors, smart pill bottles, ingestible sensors, pill counts, and utilization measures. Intervention modalities include short messaging service, mobile phone apps, websites, and interactive voice response. We provide graphical representations of intervention component categories and an element-wise breakdown of multicomponent interventions. CONCLUSIONS Many technology-based medication adherence and monitoring interventions have been studied across psychiatric disease contexts. Interventions that are useful in one psychiatric disorder may be useful in other disorders, and further research is necessary to elucidate the specific effects of individual intervention components. Our framework is directly developed from the substance use disorder and mental health treatment literature and allows for transdiagnostic comparisons and an organized conceptual mapping of interventions.

scholarly journals Technological Interventions for Medication Adherence in Adult Mental Health and Substance Use Disorders: A Systematic Review

10.2196/12493 ◽  
2019 ◽  
Vol 6 (3) ◽  
pp. e12493 ◽  
Author(s):  
Jackson M Steinkamp ◽  
Nathaniel Goldblatt ◽  
Jacob T Borodovsky ◽  
Amy LaVertu ◽  
Ian M Kronish ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Substance Use ◽  
Medication Adherence ◽  
Mobile Phone ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Intervention Component ◽  
Taxonomic Framework ◽  
Multicomponent Interventions

Background Medication adherence is critical to the effectiveness of psychopharmacologic therapy. Psychiatric disorders present special adherence considerations, notably an altered capacity for decision making and the increased street value of controlled substances. A wide range of interventions designed to improve adherence in mental health and substance use disorders have been studied; recently, many have incorporated information technology (eg, mobile phone apps, electronic pill dispensers, and telehealth). Many intervention components have been studied across different disorders. Furthermore, many interventions incorporate multiple components, making it difficult to evaluate the effect of individual components in isolation. Objective The aim of this study was to conduct a systematic scoping review to develop a literature-driven, transdiagnostic taxonomic framework of technology-based medication adherence intervention and measurement components used in mental health and substance use disorders. Methods This review was conducted based on a published protocol (PROSPERO: CRD42018067902) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review guidelines. We searched 7 electronic databases: MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, Web of Science, Engineering Village, and ClinicalTrials.gov from January 2000 to September 2018. Overall, 2 reviewers independently conducted title and abstract screens, full-text screens, and data extraction. We included all studies that evaluate populations or individuals with a mental health or substance use disorder and contain at least 1 technology-delivered component (eg, website, mobile phone app, biosensor, or algorithm) designed to improve medication adherence or the measurement thereof. Given the wide variety of studied interventions, populations, and outcomes, we did not conduct a risk of bias assessment or quantitative meta-analysis. We developed a taxonomic framework for intervention classification and applied it to multicomponent interventions across mental health disorders. Results The initial search identified 21,749 results; after screening, 127 included studies remained (Cohen kappa: 0.8, 95% CI 0.72-0.87). Major intervention component categories include reminders, support messages, social support engagement, care team contact capabilities, data feedback, psychoeducation, adherence-based psychotherapy, remote care delivery, secure medication storage, and contingency management. Adherence measurement components include self-reports, remote direct visualization, fully automated computer vision algorithms, biosensors, smart pill bottles, ingestible sensors, pill counts, and utilization measures. Intervention modalities include short messaging service, mobile phone apps, websites, and interactive voice response. We provide graphical representations of intervention component categories and an element-wise breakdown of multicomponent interventions. Conclusions Many technology-based medication adherence and monitoring interventions have been studied across psychiatric disease contexts. Interventions that are useful in one psychiatric disorder may be useful in other disorders, and further research is necessary to elucidate the specific effects of individual intervention components. Our framework is directly developed from the substance use disorder and mental health treatment literature and allows for transdiagnostic comparisons and an organized conceptual mapping of interventions.

scholarly journals 272Transdiagnostic Risk and Protective Factors for Psychopathology in Young People: A systematic review

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Miss Samantha Lynch ◽  
Matthew Sunderland ◽  
Nicola C Newton ◽  
Cath Chapman
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Substance Use ◽  
Young People ◽  
Protective Factors ◽  
Substance Use Disorders ◽  
Risk And Protective Factors ◽  
Mental Health Disorders ◽  
Diagnostic Systems ◽  
Health Disorders

Abstract Focus of Presentation Mental health and substance use disorders are among the leading causes of burden of disease worldwide. These disorders often emerge during adolescence, with risk of onset peaking between the ages 13 and 24. Despite decades of research, the underlying causes of mental health disorders remain unclear. This in part may be due to limitations of existing, categorical diagnostic systems, such as low specificity demonstrated by the high rates of co-occurring mental health disorders. A growing body of research supports a move towards dimensional, empirically derived models of psychopathology, such as the Hierarchical Taxonomy of Psychopathology (Hi-TOP) model. The present systematic review seeks to identify risk and protective factors for psychopathology in young people that occur across traditional diagnostic categories by synthesising and evaluating findings from research investigating empirically based models of psychopathology. Findings Findings will be summarised in a narrative synthesis and grouped by broad research domain, such as genetic, neurobiological, cognitive social and environmental. Conclusions/Implications The implications of these findings for the development of prevention and early intervention programs will be discussed. Key messages Empirically based models of psychopathology provide a vital opportunity to advance our knowledge of the risk and protective factors for mental health and substance use disorders, and in turn lead to the development or enhancement of prevention programs.

scholarly journals How Did The First COVID-19 Lockdown Affect Persons With Concurrent Mental Health and Substance Use Disorders in Norway? A Qualitative Study

2021 ◽  
Author(s):  
Marja Leonhardt ◽  
Morten Brodahl ◽  
Nicola Cogan ◽  
Lars Lien
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Qualitative Study ◽  
Everyday Life ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Social Life ◽  
Well Being ◽  
Structured Interview ◽  
The Everyday

Abstract Background: The outbreak of COVID-19 with its severe social restrictions touched the daily life of most people. While everyday social life becomes difficult for citizens with economic and cultural capital, it becomes even worse for vulnerable groups such as persons with mental health and substance use disorders, who are particularly vulnerable to social exclusion. The aim of this study is to investigate how the first COVID-19 lockdown affected the everyday life and health of persons with co-occurring mental health and substance use disorders.Methods: This qualitative study reports data from 17 individual interviews and one focus group of five participants, all with a self-reported mental health and substance use disorder. Interviews were conducted based on a semi-structured interview guide in September and October 2020 in a medium-sized local authority in Norway. Data were analysed using thematic analysis. A reference group of people with varied knowledge and experiences of the phenomenon were involved in study design, recruitment, data generation and analysis.Results: The analysis identified four interrelated main themes, describing how the first lockdown affected the everyday life and health of persons suffering from a mental health and substance use disorder: 1) The COVID-19 outbreak as a perceived challenge, 2) A decline in mental health and well-being, 3) Increased substance use challenges, and 4) Diverse experiences with health and social services. The results show that people with a co-occurring disorder have challenges with digital tools and/or do not have the appropriate equipment. Further, participants were not concerned about becoming infected themselves, but infecting others.Conclusion:Persons with a mental health and substance use disorder face major challenges during the COVID-19 pandemic. There is a need to maintain continuous low-threshold services especially directed towards persons with co-occurring disorders during the pandemic. Furthermore, it is important to improve the digital skills of every service user or offer alternatives to digital consultations and meetings.

Substance Use Disorders and Adoption Status: Implications for Counseling Practice

2020 ◽  
pp. 106648072095663
Author(s):  
Susan F. Branco ◽  
Connie T. Jones ◽  
Sanna Stella
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Lifetime Prevalence ◽  
Substance Use Treatment ◽  
Related Substance ◽  
Counseling Practice ◽  
Counseling Needs ◽  
To Receive

Adopted persons are at a higher risk to receive mental health and substance use treatment (Behle & Pinquart, 2016; Brodzinsky, 2013) and are also at a higher risk for a lifetime prevalence of substance use disorder (Kendler et al., 2012; Yoon et al., 2012). Despite the known risks for adopted persons, there remains a gap in counselor awareness and knowledge of the unique counseling needs of adopted persons and their families seeking substance use counseling (Atkinson et al., 2013; Brodzinsky, 2013; Lancaster et al., 2017). Therefore, we provide an overview of the related substance use research, describe the counseling needs of adopted persons and their families, and offer practice implications.

scholarly journals The prevalence and service utilisation associated with mental and substance use disorders in Lao People’s Democratic Republic: findings from a cross-sectional survey

2017 ◽  
Vol 28 (1) ◽  
pp. 54-65
Author(s):  
F. Charlson ◽  
S. Diminic ◽  
C. Choulamany ◽  
D. Santomauro ◽  
S. Raja ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Democratic Republic ◽  
Lao Pdr ◽  
Service Utilisation ◽  
Cross Sectional ◽  
The Past ◽  
A Current

Aims.An epidemiological survey was conducted to determine the prevalence of the mental and substance use disorders and ascertain patterns of mental health services utilisation in Lao People's Democratic Republic (Lao PDR) with the aim of evaluating existing gaps and opportunities in the provision of mental health services.Methods.This study was a cross-sectional, household survey of adults living within Vientiane Capital province, Lao PDR. We collected data on participant demographics, mental and physical health status, family history of mental illness and exposure to potential risk factors. It also collected data on mental health service utilisation patterns, types of health professionals and treatment being accessed, barriers to treatment and perceived need for care. The MINI International Neuropsychiatric Interview (MINI v.6.0) was also administered to assess mental disorder prevalence.Results.Age- and sex-standardised current prevalence of any disorder was estimated at 15.2% (95% CI 11.0–20.7). Alcohol dependence (5.5% (95% CI 3.2–9.6)), was the most prevalent followed by anxiety disorders (5.2% (95% CI 3.2–8.3)) and mood disorders (2.5% (95% CI 1.5–4.4)). 11.0% (95% CI 5.8–20.1) of participants with a mental and/or substance use disorder suffered from other comorbid disorders. A number of variables demonstrated significant effects in final logistic regression models, including family history, education and employment for mental disorders; and gender, numbers of hours worked per week and number of dependants for substance use disorders. Having a mental or substance use disorder was associated with an OR of 11.6 of suicidality over participants without a mental or substance use disorder (95% CI 2.8–58.5). Of the 101 participants who met criteria for a current mental or substance use disorder, only two (2.1% (95% CI 0.5–8.0)) had accessed services for their mental health in the past 12 months. No participants who had seen a health professional in the past 12 months reported getting as much help as they needed. The vast majority (89.2% (95% CI 76.5–95.4)) of participants meeting criteria for a current mental or substance use disorder reported that they had not experienced mental health problems in the past 12 months.Conclusions.This study presents the first epidemiological estimates for a range of mental and substance use disorders in the general population of the most populous province in Lao PDR. A large treatment gap exists for mental and substance use disorders in Lao PDR. This research adds value for health care and has been an important precursor to developing informed and targeted mental health policy, services and health system reform in Lao PDR.

scholarly journals A systematic review of post-release programs for women exiting prison with substance-use disorders: assessing current programs and weighing the evidence

2022 ◽  
Vol 10 (1) ◽  
Author(s):  
Layla Edwards ◽  
Sacha Kendall Jamieson ◽  
Julia Bowman ◽  
Sungwon Chang ◽  
Josie Newton ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Public Health Issue ◽  
Original Research ◽  
Adult Women ◽  
Women In Prison

Abstract Background The rising rates of women in prison is a serious public health issue. Unlike men, women in prison are characterised by significant histories of trauma, poor mental health, and high rates of substance use disorders (SUDs). Recidivism rates of women have also increased exponentially in the last decade, with substance related offences being the most imprisoned offence worldwide. There is a lack of evidence of the effectiveness of post-release programs for women. The aim of this systematic review is to synthesise and evaluate the evidence on post-release programs for women exiting prison with SUDs. Methods We searched eight scientific databases for empirical original research published in English with no date limitation. Studies with an objective to reduce recidivism for adult women (⩾18 years) with a SUD were included. Study quality was assessed using the revised Cochrane Risk of Bias tool for randomized trials (RoB2) and the Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tools. Results Of the 1493 articles, twelve (n = 3799 women) met the inclusion criteria. Recidivism was significantly reduced in five (42%) programs and substance-use was significantly reduced in one (8.3%) program. Common attributes among programs that reduced recidivism were: transitional, gender-responsive programs; provision of individualised support; providing substance-related therapy, mental health and trauma treatment services. Methodological and reporting biases were common, which impacted our ability to synthesize results further. Recidivism was inconsistently measured across studies further impacting the ability to compare results across studies. Conclusions Recidivism is a problematic measure of program efficacy because it is inconsistently measured and deficit-focused, unrecognising of women’s gains in the post-release period despite lack of tailored programs and significant health and social disadvantages. The current evidence suggests that women benefit from continuity of care from prison to the community, which incorporated gender-responsive programming and individualised case management that targeted co-morbid mental health and SUDs. Future program design should incorporate these attributes of successful programs identified in this review to better address the unique challenges that women with SUDs face when they transition back into the community.

scholarly journals The association of telomere length with substance use disorders: systematic review and meta-analysis protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Fernando Navarro-Mateu ◽  
María Rubio-Aparicio ◽  
Pedro Cayuela ◽  
Francisco-Javier Álvarez ◽  
Agustín Roca-Vega ◽  
...  
Keyword(s):  
Systematic Review ◽  
Substance Use ◽  
Telomere Length ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Meta Analysis ◽  
Nicotine Addiction ◽  
Sensitivity Analyses ◽  
Control Group ◽  
Forest Plot

Abstract Background The present protocol was designed for a systematic review and meta-analysis aimed at determining the association of telomere length with substance use disorders with the exclusion of nicotine addiction, and to identify potential moderators of the effect of telomere length. Such methodological information may provide guidance to improve the quality of future research on this important topic. Methods Potential studies will be identified through electronic databases (PubMed/MEDLINE, EMBASE, PsycINFO, and Web of Science) up from inception onwards. The inclusion criteria will include published or unpublished observational studies (cohort, case–control, and cross-sectional studies) reporting telomere length in adult patients with substance use disorder compared with a control group. Non-human studies or other study designs such as reviews, case-only, family-based, and/or population studies with only healthy participants will be excluded, as well as those focused solely on nicotine addiction. The main outcome will be telomere length in adults with substance use disorder (primary) and, specifically, in those with alcohol use disorder (secondary). Two investigators will independently evaluate the preselected studies for possible inclusion and will extract data following a standardized protocol. Disagreements will be resolved by consensus. The risk of bias of all included studies will be assessed using the Newcastle–Ottawa Quality Assessment Scale for non-randomized studies. Data will be converted into standardized mean differences as effect size index, and random-effects models will be used for the meta-analysis. Cochran’s Q statistic, I2 index, and visual inspection of the forest plot will be used to verify study heterogeneity. Subgroup analyses and meta-regressions will be conducted to ascertain heterogeneity. Several sensitivity analyses will be conducted to address the influence of potential confounding factors. Publication bias will be examined using the “funnel plot” method with Duval and Tweedie’s trim-and-fill method and Egger test. Discussion This systematic review will assess the association of telomere length with substance use disorders aside from nicotine addiction. Systematic review registration PROSPERO registration number CRD42019119785

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