How effective are remote and/or digital interventions as part of alcohol and drug treatment and recovery support? A systematic review and meta‐analysis.

Background and Aims: Although remote drug/alcohol interventions have been widely reviewed, their effectiveness specifically for people in treatment remains unclear. We aimed to systematically review the effectiveness of remote interventions (delivered by telephone or computer) in alcohol/drug treatm...

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Publicado en:Addiction Vol. 120; no. 8; pp. 1531 - 1551
Autores principales: Kwan, Irene, Burchett, Helen Elizabeth Denise, Macdowall, Wendy, D'Souza, Preethy, Stansfield, Claire, Kneale, Dylan, Sutcliffe, Katy
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Wiley-Blackwell Aug2025
Acceso en línea:Ver este registro en EBSCOhost
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        atl: How effective are remote and/or digital interventions as part of alcohol and drug treatment and recovery support? A systematic review and meta‐analysis.
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          Kwan, Irene
          Burchett, Helen Elizabeth Denise
          Macdowall, Wendy
          D'Souza, Preethy
          Stansfield, Claire
          Kneale, Dylan
          Sutcliffe, Katy
        affil: Evidence for Policy & Practice information (EPPI) Centre, Social Research Institute, University College London, London, UK
      sug:
        subj:
          Substance Use Disorders Therapy
          Alcoholism Therapy
          Telemedicine
          Recovery
          Support, Psychosocial
          Treatment Outcomes
          Human
          Funding Source
          Systematic Review
          Meta Analysis
          Male
          Female
          Adult
          Middle Age
          Medline
          Psycinfo
          Telephone
          Computers and Computerization
          Remote Consultation
          Ethanol
          Organisation for Economic Co-Operation and Development
          Descriptive Statistics
          Odds Ratio
          Confidence Intervals
          Checklists
          Digital Health
          Digital Technology
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background and Aims: Although remote drug/alcohol interventions have been widely reviewed, their effectiveness specifically for people in treatment remains unclear. We aimed to systematically review the effectiveness of remote interventions (delivered by telephone or computer) in alcohol/drug treatment and recovery support. Methods: We searched 29 databases including Medline and PsycINFO for randomised controlled trials (RCTs) of remote interventions for adults diagnosed with alcohol/drug use disorder conducted in Organization for Economic Co‐operation and Development (OECD) countries published 2004–2023. We grouped interventions according to whether they supplemented or replaced/partially replaced in‐person care. We used random effects meta‐analyses to estimate pooled odds ratios (OR) for relapse, and standardised mean differences (SMD) for days of alcohol/drug use. We appraised outcomes using Cochrane Risk of Bias 2. Results: We identified 34 RCTs (6461 participants) evaluating 42 remote interventions, with diverse therapeutic approaches. Over 70% of outcomes were judged to be at high risk‐of‐bias. When remote interventions supplemented in‐person care, there was a 39% lower odds of relapse [17 interventions; OR 0.61; 95% confidence interval (CI) = 0.46, 0.81; P = 0.001; I2 = 40.3%) and a reduction in the mean days of use (17 interventions; SMD −0.18; 95% CI = −0.28 to −0.08; P = 0.001; I2 = 27.3%) compared with in‐person care alone. When remote interventions replaced/partially replaced in‐person care, there was a 49% lower odds of relapse (7 interventions; OR 0.51; 95% CI = 0.34, 0.76; P = 0.001; I2 = 39.7%) and a very slight and uncertain reduction in mean days of use (8 interventions; SMD −0.08; 95% CI = −0.24 to 0.07; P = 0.301; I2 = 48.4%) compared with in‐person care. Subgroup analyses by type of substance and therapeutic approach were mixed and inconclusive. Conclusions: Remote interventions which supplement in‐person alcohol/drug treatment appear to reduce relapse and days of use. The evidence is less conclusive regarding remote interventions that replace/partially replace in‐person care due to a smaller body of evidence and uncertainty (days of use). High risk‐of‐bias means findings should be interpreted with caution.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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