Feasibility and Preliminary Efficacy of a Community-Based Addiction Rehabilitation Electronic System in Substance Use Disorder: Pilot Randomized Controlled Trial (Preprint)

Abstract

BACKGROUND Drug abuse has high potential to relapse and imposes an enormous burden on public health in China. Since the promulgation of the “Anti-drug law” in 2008, the community-based rehabilitation has become the primary approach to treat drug addiction. However, multi-faceted problems occurred in the implementation process, leading to low detoxification rate in the community. Mobile health (mHealth) serves as a promising tool to improve the effectiveness and efficiency of the community-based rehabilitation. Community-based addiction rehabilitation electronic system (CAREs) is an interactive system for drug users and their corresponding social workers. OBJECTIVE The study aimed to examine the feasibility and efficacy of integrated rehabilitation based on CAREs compared with the standard community-based rehabilitation from both the drug users and social workers perspective in Shanghai, China. METHODS In this pilot randomized controlled trial, 40 participants were recruited from the community in Shanghai from January to May 2019. Participants randomized to the intervention group (n=20) received integrated community rehabilitation based on CAREs, while participants in control group (n=20) received community-based rehabilitation alone for 6 months. Corresponding social workers provided service and monitored their drug use behavior as usual. The primary outcome was percentage of drug-positive samples which was submitted regularly once a week during the study course. The secondary outcome was longest period of abstinence and the change of Addiction Severity Index (ASI) from baseline in the 6th month. Usage of CAREs feature was also calculated. RESULTS After 6-month intervention, 3.3% samples in the intervention group and 7.5% in the control group were drug-positive (F = 4.358, P= .04). No significant differences between the control and intervention group in terms of longest duration of abstinence and ASI composite scores. Among the multiple features of CAREs, participants in intervention group accessed assessment and education features more frequently, while their corresponding social workers favored urine results record and viewing assessments results most. By using the CARES system, the patient's behavior and emotional state can be obtained by the social worker in a timely manner and get a timely response from the social worker. CONCLUSIONS The study preliminarily demonstrated that the feasibility and effectiveness of integrated community rehabilitation based on CAREs. CLINICALTRIAL ClinicalTrials.gov number: NCT03451344; https://clinicaltrials.gov/ct2/show/ NCT03451344 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/ NCT03451344)