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Review
. 2022 Jul 1;35(4):259-264.
doi: 10.1097/YCO.0000000000000801.

Digital approaches to continuing care

James R McKay  1
Affiliations
Review

Digital approaches to continuing care

James R McKay. Curr Opin Psychiatry. .

Abstract

Purpose of review: To provide an update of studies on the effectiveness of digital and telephonic approaches to providing remote continuing care for substance use disorders.

Recent findings: Effective continuing care can be provided via smartphone apps, text messaging, interactive voice response, and structured telephone counseling. The remote continuing care interventions with the strongest evidence of efficacy are the Addiction Comprehensive Health Enhancement Support System app and Telephone Monitoring and Counseling. Positive effects for these intervention on drinking outcomes in patients with alcohol use disorders were replicated in a recent randomized controlled study.

Summary: Continuing care is widely believed to be an important component of treatment for substance use disorders, especially for sustaining positive outcomes. However, many individuals do not attend clinic-based continuing care, due to a variety of reasons, including competing work and family responsibilities, disabilities, transportation challenges, and recently the COVID-19 pandemic. Remote continuing care, provided via smartphone apps, text messaging, and various telephonic approaches, has been shown to be effective, and could be used to provide continuing care to patients who would otherwise not receive it. Further work is needed to determine how to effectively combine more traditional continuing care with newer digitized and telephonic approaches.

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Conflict of interest statement

Conflicts of Interest

James R. McKay one of the principal developers of Telephone Monitoring and Counseling (TMC). However, the intervention is in the public domain and he does not derive any direct financial benefit from it.

References

    1. Blodgett JC, Maisel NC, Fuh IL, et al. How effective is continuing care for substance use disorders? A meta-analytic review. Journal of Substance Abuse Treatment 2014; 46:87–97. - PMC - PubMed
    1. McKay JR. Continuing care research: What we’ve learned and where we’re going. Journal of Substance Abuse Treatment 2009; 36:131–145. - PMC - PubMed
    1. Gustafson DH, McTavish FM, Chih M-Y, et al. A smartphone application to support recovery from alcoholism: A randomized controlled trial. JAMA Psychiatry 2014; 71:566–572. - PMC - PubMed
    1. Glass JE, McKay JR, Gustafson DH, et al. Treatment seeking as a mechanism of change in a randomized controlled trial of a mobile health intervention to support recovery from alcohol use disorders. Journal of Substance Abuse Treatment 2017; 77:57–66. - PMC - PubMed
    1. McKay JR, Gustafson DH, Ivey M, et al. Efficacy and comparative effectiveness of telephone and smartphone remote continuing care interventions for alcohol use disorder: A randomized controlled trial. Addiction 2021; e-publication ahead of print. DOI: 10.1111/add.15771 - DOI - PMC - PubMed

    2. **This was the first study to compare three remotely delivered continuing care interventions (e.g., TMC, ACHESS, and TMC+ACHESS) provided in addition to intensive outpatient programs (IOP) for alcohol use disorder to each other and to IOP only. The importance of being able to provide effective continuing care remotely has been made clear by the COVID 19 pandemic. Results indicated that all three interventions produced lower PDHD than IOP only during the 12 months in which they were provided.

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