A randomized trial evaluating an mHealth system to monitor and enhance adherence to pharmacotherapy for alcohol use disorders Prospective memory in substance abusers at treatment entry: associations with education, neuropsychological functioning, and everyday memory lapses. Randomized Controlled Trial of a Mobile Phone Intervention for Improving Adherence to Naltrexone for Alcohol Use Disorders A pilot study on the feasibility and acceptability of a text message-based aftercare treatment programme among alcohol outpatients. Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial Supportive text messaging for depression and comorbid alcohol use disorder: single-blind randomised trial. Preliminary Evidence for Feasibility, Use, and Acceptability of Individualized Texting for Adherence Building for Antiretroviral Adherence and Substance Use Assessment among HIV-Infected Methamphetamine Users A Cognitive Behavioral Therapy-Based Text Messaging Intervention for Methamphetamine Dependence Perception of patients with alcohol use disorder and comorbid depression about the usefulness of supportive text messages. Development of a personalized bidirectional text messaging tool for HIV adherence assessment and intervention among substance abusers. SMS text messaging as a means of increasing recall of therapy goals in brain injury rehabilitation: A single-blind within-subjects trial The efficacy of SMS text messages to compensate for the effects of cognitive impairments in schizophrenia. Six-months outcomes of a randomised trial of supportive text messaging for depression and comorbid alcohol use disorder. A surveillance tool using mobile phone short message service to reduce alcohol consumption among alcohol-dependent patients.
Background Nonadherence to prescribed medication regimens is a substantial barrier to the pharmacological management of alcohol use disorders . The availability of low-cost , sustainable interventions that maximize medication adherence would likely lead to improved treatment outcomes . Mobile health ( mHealth ) technologies are increasingly being adopted as a method of delivering behavioral health interventions and represent a promising tool for adherence interventions . We are evaluating a cell-phone – based intervention called AGATE that seeks to enhance adherence with regular text-messaging . Methods / Design A r and omized controlled effectiveness trial in the context of an eight-week open label naltrexone efficacy trial delivered in a naturalistic clinical setting . Treatment-seeking heavy drinkers ( N = 105 ) are currently being recruited and r and omly assigned to the AGATE intervention or a control condition .  Daily measures of alcohol use and medication side effects are being recorded via cell phone in both conditions . Additionally , participants r and omized to the AGATE condition receive medication reminders via SMS text message according to a schedule that adjusts according to their level of adherence . Discussion Results from this trial will provide initial information about the feasibility and efficacy of mHealth interventions for improving adherence to alcohol pharmacotherapies . Trial Registration NCT01349985 Individuals with substance use disorders ( SUDs ) commonly report lapses in prospect i ve memory ( PM ) in their daily lives ; however , our underst and ing of the profile and predictors of laboratory-based PM deficits in SUDs and their associations with everyday PM failures is still very preliminary . The current study examined these important questions using well-vali date d measures of self-report and laboratory-based PM in a mixed cohort of 53 SUD individuals at treatment entry and 44 healthy adults . Consistent with prior research , the SUD group endorsed significantly more self-cued and environmentally based PM failures in their daily lives . Moreover , the SUD group demonstrated significantly lower time-based PM performance , driven largely by cue detection errors . The effect of SUDs on PM was particularly strong among participants with fewer years of education . Within the SUD cohort , time-based PM was correlated with clinical measures assessing executive functions , retrospective memory , and psychomotor speed . Importantly , time-based PM was uniquely associated with elevated PM failures in daily lives of the SUD participants , independent of current affective distress and other neurocognitive deficits . Findings suggest that individuals with SUD are vulnerable to deficits in PM , which may in turn increase their risk for poorer everyday functioning outcomes ( e.g. , treatment non-compliance ) Background Naltrexone is a front-line treatment for alcohol use disorders , but its efficacy is limited by poor medication adherence . This r and omized controlled trial evaluated whether a mobile health intervention could improve naltrexone adherence . Methods Treatment-seeking participants with an alcohol use disorder ( N = 76 ) were r and omized to intervention and control conditions . All participants received naltrexone ( 50 mg/day ) with a medication event monitoring system ( MEMS ) and a prepaid smartphone , and received a daily text message querying medication side effects , alcohol use , and craving . Those in the intervention arm received additional medication reminders and adherence assessment via text message . Results The primary outcome , proportion of participants with adequate adherence ( defined as ≥80 % of prescribed doses taken through Week 8) , did not differ between groups in intent-to-treat analyses ( p = .34 ) . Mean adherence at study midpoint ( Week 4 ) was 83 % in the intervention condition and 77 % in the control condition ( p = .35 ) . Survival analysis found that the intervention group sustained adequate adherence significantly longer ( M = 19 days [ 95 % CI = 0.0–44.0 ] ) than those in the control group ( M = 3 days [ 95 % CI = 0.0–8.1 ] ) during the first month of treatment ( p = .04 ) . Medication adherence did not predict drinking outcomes . Conclusions These results suggest that in the context of daily monitoring and assessment via cell phone , additional text message reminders do not further improve medication adherence . Although this initial trial does not provide support for the efficacy of text messaging to improve adherence to pharmacotherapy for alcohol use disorders , additional trials with larger sample s and alternate design s are warranted . Trial Registration Clinical Trials.gov : AIMS To test the feasibility , acceptability and initial effectiveness of a text message-based aftercare treatment programme among alcohol out patients . METHODS Clients treated for alcohol use disorders from three Swiss outpatient alcohol treatment centres were invited by their counsellors to participate in a study testing an interactive aftercare programme employing the use of text messages and personal phone calls . Fifty study participants were r and omly assigned to either the 6-month aftercare programme ( n = 25 ) or treatment as usual ( n = 25 ) . The intervention consisted of ( a ) monitoring of self-selected drinking goals at regular intervals , ( b ) motivational text messages to stick to self-selected drinking goals and ( c ) proactive telephone calls from counsellors when participants neglected to stick to their drinking goals or expressed a need for support . Follow-up interviews were conducted 6 months after r and omization . RESULTS Throughout the programme , participants received a total of 421 text message prompts . Out of these , participants provided valid replies to 371 ( 88.1 % ) within 48 h. Out of the 25 participants in the intervention group , 11 ( 44.0 % ) sent at least one call-for-help reply . Based on complete case data , at risk alcohol use at follow-up was 41.7 % in the control group and 28.6 % in the intervention group ( OR = 0.56 , 95 % CI = 0.16 - 1.95 , P = 0.36 ) . CONCLUSIONS The interactive low-intensive aftercare programme was well accepted by the participants . Testing its efficacy within an adequately powered r and omized controlled trial might be reasonable Summary Background Smoking cessation programmes delivered via mobile phone text messaging show increases in self-reported quitting in the short term . We assessed the effect of an automated smoking cessation programme delivered via mobile phone text messaging on continuous abstinence , which was biochemically verified at 6 months . Methods In this single-blind , r and omised trial , undertaken in the UK , smokers willing to make a quit attempt were r and omly allocated , using an independent telephone r and omisation system , to a mobile phone text messaging smoking cessation programme ( txt2stop ) , comprising motivational messages and behavioural-change support , or to a control group that received text messages unrelated to quitting . The system automatically generated intervention or control group texts according to the allocation . Outcome assessors were masked to treatment allocation . The primary outcome was self-reported continuous smoking abstinence , biochemically verified at 6 months . All analyses were by intention to treat . This study is registered , number IS RCT N 80978588 . Findings We assessed 11 914 participants for eligibility . 5800 participants were r and omised , of whom 2915 smokers were allocated to the txt2stop intervention and 2885 were allocated to the control group ; eight were excluded because they were r and omised more than once . Primary outcome data were available for 5524 ( 95 % ) participants . Biochemically verified continuous abstinence at 6 months was significantly increased in the txt2stop group ( 10·7 % txt2stop vs 4·9 % control , relative risk [ RR ] 2·20 , 95 % CI 1·80–2·68 ; p<0·0001 ) . Similar results were obtained when participants that were lost to follow-up were treated as smokers ( 268 [ 9 % ] of 2911 txt2stop vs 124 [ 4 % ] of 2881 control [ RR 2·14 , 95 % CI 1·74–2·63 ; p<0·0001 ] ) , and when they were excluded ( 268 [ 10 % ] of 2735 txt2stop vs 124 [ 4 % ] of 2789 control [ 2·20 , 1·79–2·71 ; p<0·0001 ] ) . No significant heterogeneity was shown in any of the prespecified subgroups . Interpretation The txt2stop smoking cessation programme significantly improved smoking cessation rates at 6 months and should be considered for inclusion in smoking cessation services . Funding UK Medical Research Council , Primary Care Research Networks BACKGROUND Mobile phone text message technology has the potential to improve outcomes for patients with depression and co-morbid Alcohol Use Disorder ( AUD ) . AIMS To perform a r and omised rater-blinded trial to explore the effects of supportive text messages on mood and abstinence outcomes for patients with depression and co-morbid AUD . METHODS Participants ( n=54 ) with a DSM IV diagnosis of unipolar depression and AUD who completed an in-patient dual diagnosis treatment programme were r  and omised to receive twice daily supportive text messages ( n=26 ) or a fortnightly thank you text message ( n=28 ) for three months . Primary outcome measures were Beck 's Depression Inventory ( BDI-II ) scores and Cumulative Abstinence Duration ( CAD ) in days at three months . TRIAL REGISTRATION NCT0137868 . RESULTS There was a statistically significant difference in three month BDI-II scores between the intervention and control groups ; 8.5 ( SD=8.0 ) vs. 16.7 ( SD=10.3 ) respectively after adjusting for the baseline scores , F ( 1 , 49)=9.54 , p=0.003 , η(p)(2)=0.17 . The mean difference in change BDI-II scores was -7.9 ( 95 % CI -13.06 to -2.76 , Cohen'sd=0.85 ) . There was a trend for a greater CAD in the text message group than the control group : 88.3 ( SD=6.2 ) vs. 79.3 ( SD=24.1 ) , t=1.78 , df=48 , p=0.08 . LIMITATIONS Limitations of the study include the small sample size , the potential for loss of rater blinding and the lack of long term follow-up to determine the longer term effects of the intervention . CONCLUSION Supportive text messages have the potential to improve outcomes for patients with comorbid depression and alcohol dependency syndrome The feasibility , use , and acceptability of text messages to track methamphetamine use and promote antiretroviral treatment ( ART ) adherence among HIV-infected methamphetamine users was examined . From an ongoing r and omized controlled trial , 30-day text response rates of participants assigned to the intervention ( individualized texting for adherence building ( iTAB ) , n = 20 ) were compared to those in the active  comparison  condition ( n = 9 ) . Both groups received daily texts assessing methamphetamine use , and the iTAB group additionally received personalized daily ART adherence reminder texts .  Response rate for methamphetamine use texts was 72.9 % with methamphetamine use endorsed 14.7 % of the time . Text-derived methamphetamine use data was correlated with data from a structured substance use interview covering the same time period ( P < 0.05 ) . The iTAB group responded to 69.0 % of adherence reminder texts ; among those responses , 81.8 % endorsed taking ART medication . St and ardized feedback question naire responses indicated little difficulty with the texts , satisfaction with the study , and beliefs that future text-based interventions would be helpful . Moreover , most participants believed the intervention reduced methamphetamine use and improved adherence . Qualitative feedback regarding the intervention was positive . Future studies will refine and improve iTAB for optimal acceptability and efficacy . This trial is registered with Clinical Trials.gov NCT01317277 Abstract Psychosocial treatments for methamphetamine dependence are of limited effectiveness . Thus , a significant need exists for add-on therapy for this substance user disorder . The aim of this study was to develop and test a novel text messaging intervention for use as an adjunct to cognitive behavioral group therapy for methamphetamine users .  Text messaging has the potential to support patients in real-time , around the clock . We convened two meetings of an expert panel , held three focus groups in current and former users , and conducted 15 semi-structured interviews with in-treatment users in order to develop a fully automated , cognitive behavioral therapy-based text messaging intervention . We then conducted a r and omized , crossover pre-test in five users seeking treatment . Participants ’ ratings of ease of use and functionality of the system were high . During the pre-test , we performed real-time assessment s via text messaging on daily methamphetamine use , craving levels , and the perceived usefulness of messages ; 79 % of scheduled assessment s were collected . The odds of messages being rated as “ very ” or “ extremely ” useful were 6.6 times ( 95 % CI : 2.2 , 19.4 ) higher in the active vs. placebo periods . The intervention is now ready for testing in r and omized clinical trials BACKGROUND Very little is known about the perception of patients with alcohol use disorder ( AUD ) and comorbid depression about the usefulness of supportive text messages . OBJECTIVE To examine the perception of patients with AUD and comorbid depression about the usefulness of supportive text messages . METHODS Participants ( n=26 ) with a DSM IV diagnosis of AUD and depression and completing an in-patient dual diagnosis treatment programme had twice daily supportive text messages delivered to their mobile phones for three months as part of a r and omised trial . Participants were contacted at the end of the third month to obtain their views regarding the usefulness of the supportive text messages using a semi-structured question naire . RESULTS Overall , 24 out of 26 patients were contactable for feedback ( 92 % response rate ) . Eighteen ( 75 % ) patients reported that the text messages always or often reminded them to remain abstinent from alcohol . Again , 20 ( 83 % ) patients reported that the intervention had played a useful role in helping to improve their mental health , in particular , in serving as a motivation for recovery and in preventing relapse . CONCLUSIONS Patients with AUD and depression perceive that supportive text messages help them to remain abstinent from alcohol and also improve upon their mental wellbeing We describe the development of a two-way text messaging intervention tool for substance users who are non-adherent with HIV medications , and examine message flow data for feasibility and acceptability . The assessment and intervention tool , TxText , is fully automated , sending participants mood , substance use , and medication adherence queries by text message . Participants respond , the tool recognizes the category of response , and sends the personalized intervention message that participants design ed in return . In 10months , the tool sent 16,547 messages ( half initial , half follow-up ) to 31 participants assigned to the TxText condition , who sent 6711 messages in response to the initial messages . Response rates to substance use ( n=2370 ) , medication ( n=2918 ) and mood ( n=4639 ) queries were 67 , 69 , and 64 % , respectively . Responses indicating medication adherence , abstinence from substances , and good moods were more common than negative responses . The TxText tool can send messages daily over a 3month period , receive responses , and decode them to deliver personalized affirming or intervention messages . While we await the outcomes of a pilot r and omized trial , the process analysis shows that TxText is acceptable and feasible for substance abusers with HIV , and may serve as a complement to HIV medical care A single-blind within-subjects trial was used to test the efficacy of sending SMS text messages to patients with a traumatic brain injury as a means of improving their recall of rehabilitation goals .  Eleven participants were recruited from two community-based rehabilitation centres and were sent text messages relating to three r and omly selected goals from a selection of six current goals three times per day for 14 days . Participants ’ recall of their rehabilitation goals was assessed at baseline , seven days , and 14 days via free recall and cued recall procedures . Results showed that goals in the “ text ” condition were recalled better than goals in the “ no text ” condition . Practical applications and extensions are discussed BACKGROUND AND AIMS Many people with schizophrenia have severe cognitive impairments that hamper their activities . The effect of pharmacological and behavioural interventions on cognitive functioning has been demonstrated , but even after successful intervention considerable impairments can remain . Therefore , we sought for alternative ways to help patients cope with the effects of their cognitive impairments . In the present study , we have evaluated the efficacy of short message service ( SMS ) text messages to compensate for the effects of cognitive impairments in schizophrenia in daily life . DESIGN A waiting list controlled trial was conducted : patients were quasi-r and omly assigned to an A-B-A ( baseline-intervention-follow-up ) condition or an A-A-B-A condition that included an additional 7-week waiting list . The waiting list was included to control for the effect of time on relevant outcome . METHOD Sixty-two people with schizophrenia or related psychotic disorders were included in the study . All patients showed impaired goal -directed behaviour in daily life-situations . Patients were prompted with SMS text messages to improve their everyday functioning . The primary outcome measure was the percentage of goals achieved . RESULTS The overall percentage of goals achieved increased with prompting , while performance dropped to baseline level after withdrawing the prompts . Keeping appointments with mental health workers and carrying out leisure activities increased with prompting , while medication adherence and attendance at training sessions remained unchanged . A majority of the patients enjoyed receiving the SMS text messages . DISCUSSION Prompting can significantly improve achievement of a number of relevant goals . For other goals , combining prompting with interventions that enhance motivation seems indicated BACKGROUND AND OBJECTIVES We have previously reported that supportive text messages delivered twice daily for three months have the potential to provide personalised support for patients with depression and co-morbid Alcohol Use Disorder ( AUD ) . In this study we report the six months outcomes . METHODS Participants ( n=54 ) with a DSM IV diagnosis of unipolar depression and AUD who completed an in-patient dual diagnosis treatment programme were r and omised to receive daily twice supportive text messages ( n=26 ) or a fortnightly thank you text message ( n=28 ) for three months . Primary outcome measures at six months were Beck 's Depression Inventory ( BDI-II ) scores and Cumulative Abstinence Duration ( CAD ) . TRIAL REGISTRATION NCT0137868 . RESULTS Unlike at three months , there was no statistically significant difference in six months BDI-II scores between the intervention ( n=24 ) and control ( n=24 ) groups ; 13.28 ( SD=8.7 ) vs. 15.08 ( SD=11.37 ) respectively after adjusting for the baseline scores , F ( 1 , 45)=0.192 , p=0.66 . There was also no significant difference in CAD between the text message group and the control group : 84.14 days ( 9.20 ) vs. 74.73 days ( 28.97 ) , t=1.422 , df=41 , p=0.16 . However , patients in the intervention group had significantly higher days to first drink compared to those in the control group : 119.9 ( 47.7 ) vs. 62.4 ( 44.9 ) , t=2.99 , df=22 , p=0.01 . LIMITATIONS Limitations of the study include the small sample size and the potential for loss of rater blinding . CONCLUSION The effects of supportive text message intervention were not sustained beyond the period that the patients were receiving the intervention BACKGROUND In public health setting s , short message service ( SMS ) appears to be a promising low-cost modality for reducing alcohol consumption . Here , we test a simple interactive SMS-based helpline with detoxified alcohol-dependent patients to extend findings to curative setting s. METHODS This controlled , prospect i ve , 2-group before-after block-assignment , open pilot study tested the feasibility and efficacy of an 8-week  outpatient interactive mobile phone SMS intervention ( n = 42 ) against treatment as usual ( TAU ; n = 38 ) after inpatient detoxification . Patients were asked whether they needed any help via an automatically generated text message twice a week . A therapist called the individual back when notified . Alcohol consumption was assessed using the telephone version of Form-90 4 and 8 weeks after discharge from inpatient detoxification . The primary end point was defined as attaining low-risk consumption ( males ≤30 g or 3.75 units per drinking day ( DDD ) ; females ≤20 g or 2.5 units per DDD ) 8 weeks after discharge . Missing data were replaced by multiple imputation . RESULTS Among all messages sent , 20.5 % were followed by a phone call . Feasibility and acceptability were good , as indicated by successful implementation of the SMS procedure and the rapid inclusion of patients . Adherence was satisfactory with 57.14 % of the participants replying to at least 50 % of the prompts . Patients reported a typical preadmission DDD of 281.25 ± 244.61 g. In the SMS group , 55.7 % of 42 patients , and 40 % of 38 patients in the TAU group , achieved low-risk consumption ( risk diff : 0.16 ; 95 % CI -0.06 to 0.37 ; p = 0.122 ) . CONCLUSIONS In detoxified alcohol-dependent patients , relapse prevention based on SMS was well received and implemented efficiently and rapidly . An adequately powered multicenter study is currently being conducted to test the nonsignificant but encouraging findings of this exploratory study with more rigorous trial methods ( IS RCT N78350716 )
ISSUES Mobile phone use has increased dramatically and concurrent with rapid developments in mobile phone-based health interventions .
The integration of text messaging interventions promises to optimise the delivery of care for persons with substance dependence with minimal disruption to clinical workflows .
We conducted a systematic review to assess the acceptability , feasibility and clinical impact of text messaging interventions for persons with illicit drug and alcohol dependence .