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Blended smartphone intervention for patients in opioid maintenance treatment in Iran: protocol for a randomized controlled trial


Boumparis, Nikolaos; Noroozi, Alireza; Naghizadeh, Eisa; Meyer, Andreas; Wenger, Andreas; Rahimi-Movaghar, Afarin; Schaub, Michael P (2023). Blended smartphone intervention for patients in opioid maintenance treatment in Iran: protocol for a randomized controlled trial. BMC Psychiatry, 23(1):518.

Abstract

Background
The pattern of substance use in Iran is characterized by a high prevalence of opioid use and opioid use disorder (OUD). Although opioid maintenance therapy (OMT) has been introduced in Iran, approximately 50% of people with opioid use disorder remain unreached. Moreover, psychosocial treatment of OUD and common mental health symptoms during OMT is limited. Digital interventions have been shown to improve psychological distress, depression, anxiety, and post-traumatic stress disorder symptoms. In addition, providing psychoeducation and risk reduction counseling to prevent communicable diseases like HIV and infectious hepatitis is common via the Internet. However, despite these promising advances, no smartphone intervention in OMT has been investigated for the treatment of OUD and common comorbid mental health symptoms.

Objective
We examine the effectiveness of adding a blended smartphone intervention based on community reinforcement approach, motivational interviewing- and cognitive behavioral therapy compared to OMT as usual that aims to improve OMT outcomes and addresses common mental health symptoms in OMT patients in Iran.

Method
Adults with opioid dependence entering 8 treatment centers in Tehran, Iran will be randomly assigned to receive either OMT plus a smartphone intervention or OMT as usual. The primary outcomes will be the percentage of negative urine tests for illicit, non-prescribed use of opioids (opium, heroin, tramadol) and treatment retention. Secondary outcomes will include the longest period of abstinence from the illicit, non-prescribed use of opioids (opium, heroin, and tramadol) confirmed by urine samples, changes in communicable disease risk-taking behaviors, changes in stress and common mental health symptoms, and client satisfaction. Data analysis will follow the intention-to-treat principle and employ (generalized) linear mixed models.

Discussion
This study will provide substantial knowledge for designing effective blended interventions for OUD. Moreover, it will investigate if treatment retention and OMT-related outcomes and common mental health symptoms can be improved by adding a smartphone intervention to OMT.

Trial Registration
https://en.irct.ir/trial/53578.

Abstract

Background
The pattern of substance use in Iran is characterized by a high prevalence of opioid use and opioid use disorder (OUD). Although opioid maintenance therapy (OMT) has been introduced in Iran, approximately 50% of people with opioid use disorder remain unreached. Moreover, psychosocial treatment of OUD and common mental health symptoms during OMT is limited. Digital interventions have been shown to improve psychological distress, depression, anxiety, and post-traumatic stress disorder symptoms. In addition, providing psychoeducation and risk reduction counseling to prevent communicable diseases like HIV and infectious hepatitis is common via the Internet. However, despite these promising advances, no smartphone intervention in OMT has been investigated for the treatment of OUD and common comorbid mental health symptoms.

Objective
We examine the effectiveness of adding a blended smartphone intervention based on community reinforcement approach, motivational interviewing- and cognitive behavioral therapy compared to OMT as usual that aims to improve OMT outcomes and addresses common mental health symptoms in OMT patients in Iran.

Method
Adults with opioid dependence entering 8 treatment centers in Tehran, Iran will be randomly assigned to receive either OMT plus a smartphone intervention or OMT as usual. The primary outcomes will be the percentage of negative urine tests for illicit, non-prescribed use of opioids (opium, heroin, tramadol) and treatment retention. Secondary outcomes will include the longest period of abstinence from the illicit, non-prescribed use of opioids (opium, heroin, and tramadol) confirmed by urine samples, changes in communicable disease risk-taking behaviors, changes in stress and common mental health symptoms, and client satisfaction. Data analysis will follow the intention-to-treat principle and employ (generalized) linear mixed models.

Discussion
This study will provide substantial knowledge for designing effective blended interventions for OUD. Moreover, it will investigate if treatment retention and OMT-related outcomes and common mental health symptoms can be improved by adding a smartphone intervention to OMT.

Trial Registration
https://en.irct.ir/trial/53578.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Swiss Research Institute for Public Health and Addiction
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Psychiatry and Mental Health
Uncontrolled Keywords:Psychiatry and Mental health
Language:English
Date:18 July 2023
Deposited On:14 Sep 2023 10:49
Last Modified:30 May 2024 01:45
Publisher:BioMed Central
ISSN:1471-244X
OA Status:Gold
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1186/s12888-023-05007-0
PubMed ID:37464337
Other Identification Number:PMCID: PMC10354992
Project Information:
  • : FunderSNSF
  • : Grant ID194093
  • : Project TitleGuided smartphone-based treatment for patients in opioid maintenance treatment in Iran - transdiagnostic treatment for substance use and common mental disorders
  • : FunderSNSF
  • : Grant ID194093
  • : Project TitleGuided smartphone-based treatment for patients in opioid maintenance treatment in Iran - transdiagnostic treatment for substance use and common mental disorders
  • : FunderSNSF
  • : Grant ID194093
  • : Project TitleGuided smartphone-based treatment for patients in opioid maintenance treatment in Iran - transdiagnostic treatment for substance use and common mental disorders
  • : FunderSNSF
  • : Grant ID194093
  • : Project TitleGuided smartphone-based treatment for patients in opioid maintenance treatment in Iran - transdiagnostic treatment for substance use and common mental disorders
  • : FunderSNSF
  • : Grant ID194093
  • : Project TitleGuided smartphone-based treatment for patients in opioid maintenance treatment in Iran - transdiagnostic treatment for substance use and common mental disorders
  • : FunderSNSF
  • : Grant ID194093
  • : Project TitleGuided smartphone-based treatment for patients in opioid maintenance treatment in Iran - transdiagnostic treatment for substance use and common mental disorders
  • : FunderSNSF
  • : Grant ID194093
  • : Project TitleGuided smartphone-based treatment for patients in opioid maintenance treatment in Iran - transdiagnostic treatment for substance use and common mental disorders
  • Content: Published Version
  • Language: English
  • Licence: Creative Commons: Attribution 4.0 International (CC BY 4.0)