Digital interventions for opioid use disorder treatment: A systematic review of randomized controlled trials

Sarah Kanana Kiburi; Elizabeth Ngarachu; Andrew Tomita; Saeeda Paruk; Bonginkosi Chiliza

doi:10.1016/j.jsat.2022.108926

Digital interventions for opioid use disorder treatment: A systematic review of randomized controlled trials

J Subst Abuse Treat. 2023 Jan:144:108926. doi: 10.1016/j.jsat.2022.108926. Epub 2022 Oct 31.

Authors

Sarah Kanana Kiburi¹, Elizabeth Ngarachu², Andrew Tomita³, Saeeda Paruk⁴, Bonginkosi Chiliza⁵

Affiliations

¹ Discipline of Psychiatry, Nelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa; Department of Psychiatry, Mbagathi Hospital, Nairobi, Postal address P.O. Box 20725-00202, Nairobi, Kenya. Electronic address: sarahkiburi@gmail.com.
² Department of Psychiatry, Mathari Teaching and Referral Hospital, Nairobi, Kenya.
³ Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa; KwaZulu-Natal Research Innovation and Sequencing Platform, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa. Electronic address: Tomita@ukzn.ac.za.
⁴ Discipline of Psychiatry, Nelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa.
⁵ Discipline of Psychiatry, Nelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa. Electronic address: chilizab@ukzn.ac.za.

PMID: 36356329
DOI: 10.1016/j.jsat.2022.108926

Abstract

Introduction: Opioid use disorders are associated with a high burden of disease and treatment gap. Digital interventions can be used to provide psycho-social treatment for opioid use disorders, as an alternative to or together with face-to-face interventions. This review aimed to assess the application and effectiveness of digital interventions to treat opioid use disorder globally.

Methods: The study team searched four electronic databases (PubMed, Psych INFO, Web of Science and Cochrane Central register of controlled trials). The inclusion criteria were: randomized controlled trials, assessment for opioid use before and at least once following intervention, and use of digital interventions. The primary outcomes were opioid use and/or retention in treatment, with data being summarized in tables and a narrative review presented.

Results: The initial database search yielded 3542 articles, of which this review includes 20. Nineteen were conducted among adults in the United States. The digital interventions used included web-based, computer-based, telephone calls, video conferencing, automated self-management system, mobile applications and text messaging. They were based on therapeutic education systems, community reinforcement approaches, cognitive behavior therapy, relapse prevention, brief interventions, supportive counselling and motivational interviewing. The studies had mixed findings; of the 20 studies, 10 had statistically significant differences between the treatment groups for opioid abstinence, and four had significant differences for treatment retention. Comparisons were difficult due to varying methodologies. Participants rated the interventions as acceptable and reported high rates of satisfaction.

Conclusion: The use of digital interventions for opioid use disorder treatment was acceptable, with varying levels of effectiveness for improving outcomes, which is influenced by participant and intervention delivery factors. Further studies in different parts of the world should compare these findings, specifically in low- and middle-income countries.

Keywords: Digital; Interventions; Opioid use disorder; Systematic review; Treatment.

Publication types

Review
Systematic Review

MeSH terms

Adult
Analgesics, Opioid / therapeutic use
Humans
Motivational Interviewing*
Opioid-Related Disorders* / drug therapy
Randomized Controlled Trials as Topic
Text Messaging*

Substances

Analgesics, Opioid