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Tag: mobile-based interventions

Where Do We Go from Here on Digital Therapeutics?

Article Excerpt: South Korea is the only country to officially recognize digital therapeutics as a category. Nevertheless, the concept of software-based tools designed to manage or treat medical conditions has received enormous attention in the U.S. as proponents tout their potential to both widen access to care and improve patient outcomes. This optimism has driven significant financial investment in the sector, which ballooned to $3.4 billion in 2021. However, recent setbacks and billions of dollars in bankruptcies in 2023 indicate that the field is stagnating. Though industry voices point to regulatory hurdles as the culprit, deeper structural challenges threaten the future of “software as a medical device” and other digital health technologies, as categorized by the Food and Drug Administration.

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Article Source: Stat News


Developing digital interventions for a post-Covid world: A smartphone- based approach-avoidance training to reduce alcohol craving.

Peerenboom N, Guzman NV, Kvamme T, Ritou V, Casero V, Voon V. Developing digital interventions for a post-Covid world: A smartphone-based approach-avoidance training to reduce alcohol craving. Scand J Psychol. 2023;doi:10.1111/sjop.12974.

This article provided proof of concept and randomized control data for a novel smartphone version of the Approach Avoidance Task (AAT). Patients with addiction disorders show preferential bias towards drug stimuli (faster to approach, longer to avoid) in lab-based AAT. This bias towards stimuli that are associated with drug use is thought to increase craving and eventual drug use. One method of altering this bias is through cognitive bias modification (CBM). Here, the research team assessed their novel gamified CBM intervention to determine the possible efficacy of home-based training. In the proof of concept study, 62 UK-based adults who consumed 14+ units of alcohol per week were either waitlisted (n = 32) or received the training (n = 30). Image-induced craving decreased from baseline at a 1-day follow-up in the training group (p = 0.007) but not the waitlist group (p = 0.102). In the subsequent experiment, 118 individuals who consumed 20+ units of alcohol per week were randomly assigned to the novel training (n = 56) or active control (n = 62). Training effects at a 1-week follow-up revealed a decrease in prior week risky alcohol behavior  (p = 0.007) and alcohol craving (p = 0.003). However, training did not reduce image-induced craving (p = 0.108) or alter alcohol stimuli bias (all p > 0.05). This data provides support for the use of this novel smartphone-delivered training in reducing cravings for alcohol and weekly risk for use. However, the lack of impact on alcohol approach bias remains an open area of research. Due to the limitations in this population, a larger study is currently being conducted by the authors using individuals seeking treatment for alcohol use.


Systematic review of economic evaluations for internet- and mobile-based interventions for mental health problems

Kählke F, Buntrock C, Smit F, Ebert DD. Systematic review of economic evaluations for internet- and mobile-based interventions for mental health problems. npj Digit. Med. 5, 175 (2022).

A systematic review was conducted to summarize the cost-effectiveness of internet and mobile-based interventions (IMIs) for mental health disorders and symptoms. This review also assessed methodological quality of included studies. The literature search identified studies of psychological interventions provided in an online setting to treat mental health disorders or any type of psychological symptoms regardless of participant age. Studies had to be randomized controlled trials that included a full economic evaluation. A total of 4,044 articles were identified, of which 36 articles met eligibility criteria. Sixty-five economic evaluations were conducted. The most commonly targeted mental health problem was major depressive disorder or depressive symptoms, followed by anxiety. Cost-effectiveness was determined using the threshold of at or below £30,000 per quality-adjusted life year (QALY) gained. Overall, the majority of economic evaluations of IMIs (n=56) presented evidence of cost-effectiveness. Guided IMIs (i.e., interventions that include support by a provider via email, chat, or automated feedback delivery) were likely to be cost-effective in depression and anxiety studies. Methodological quality of the cost-effectiveness analyses was mostly evaluated as good, however a few studies showed high risk of bias. Researchers found high heterogeneity across studies due to factors such as costing methods, design, comparators, and outcomes used. Overall, these findings suggest the cost-effectiveness of IMIs and include new evidence in under-researched disorders such as obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), stress, and sleep. Future research is needed to continue to target underrepresented disorders (e.g., panic disorder and specific phobias), as well as research in low- and middle-income countries.