Mobile Messaging Assisted Treatment (MMAT) for Patients with Methamphetamine Use Disorder: A Preliminary Randomized Controlled Trial (Preprint)
Authors: Lee Chun-Hung , Liaw Guan-Hsiung , Yang Wu-Chuan , Liu Yu-Hsin 
Published: January 2021

BACKGROUND

Methamphetamine (MA) use disorder can cause various physical and psychological harms. Despite current evidence demonstrating the therapeutic effects of psychosocial interventions, finding an approach to increase patient adherence to treatment remains a real-world challenge. The rapid development of new technologies, such as mobile health (mHealth) systems, suggests the potential to provide real-time personalized care at any time and from any location, minimize barriers to treatment, maximize use, and promote the dissemination of accessible therapeutic tools in at-risk populations.

OBJECTIVE

Objectives of our study investigated the feasibility and effectiveness of implementing mHealth technology in the treatment of MA use disorder.

METHODS

The inclusion criteria were (a) a diagnosis of MA abuse or dependence as defined by the DSM-IV-TR (b) age between 18 and 65 years, (c) no initial diagnosis of severe physical or mental illness, such as schizophrenia or bipolar I disorder, at baseline of the survey, and (d) willingness to participate in standard outpatient treatment for 1 year. Participants were randomly allocated to either a mobile messaging–assisted treatment (MMAT) group which delivered relapse prevention and recovery skills or a control group following simple randomization procedures (computerized random numbers) without blinding. All participants were followed for 6 months. Treatment retention and results of monthly urine tests were analysed as outcome measures. Feasibility and participant satisfaction were also assessed based on patients’ experiences with MMAT.

RESULTS

50 participants were allocated to MMAT group and 49 to control. The average retention was 142.42 ± 60.54 days for the MMAT group and 118.12 ± 73.41 days for the control group, with no significant differences between the two treatment groups (df = 1, p = .099). Compared with the control group, the MMAT group had fewer MA-positive urine samples (19.5% vs 29.6%, F = 9.116, p = .003). Moreover, the proportion of MA-positive urine samples was positively correlated with the frequency of MA use (r = .323, p = .001), severity of MA use disorder (r = 0.364, p < .001), and polysubstance use (r = .212, p = .035) and negatively correlated with readiness to change (r = -.330, p = .001). At 6-month follow-up, 55 participants who completed the study reported high satisfaction with receiving MMAT. There was no significant adverse effects reported.

CONCLUSIONS

Participants in this study diagnosed as having MA use had high adherence to MMAT, generally positive treatment outcomes, and favorable acceptance, which indicates that this type of intervention is feasible for individuals with MA use disorder. Therefore, this study supports the efficacy and feasibility of using mobile phones for treating people who use MA. Future studies should investigate MMAT’s ability to (a) engage patients in the assessment of their own symptoms and daily functioning, (b) increase patients’ self-awareness and self-management of symptoms, (c) improve patients’ ability to identify triggers and track their own disease progression, and (d) increase patients’ willingness to seek care when necessary.

CLINICALTRIAL

Study Registry: ISRCTN16586487 (https://doi.org/10.1186/ISRCTN16586487)