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Mobile apps may help prevent substance abuse relapses

Can giving smartphones to people with substance use disorders improve the quality of care at the same time as it reduces health care costs? A team of scholars at UW-Madison and Dartmouth College thinks so, and has won a federal grant to create and test mobile apps to deliver tested treatment and relapse prevention tools through these devices.

The $3.5 million grant from the National Institute on Drug Abuse will support this work by the Center for Health Enhancement Systems Studies (CHESS) at UW-Madison. Led by David Gustafson, research professor of industrial and systems engineering and director of CHESS, and Lisa Marsch, professor of psychiatry at Dartmouth, the project will use smartphones and tablets to integrate drug abuse treatment in primary care settings at federally qualified health centers (FQHCs).

"We have a uniquely qualified group to find the best ways to use technology to reduce relapse and costs at the same time," Gustafson says, noting the team also includes specialists in addiction medicine, behavioral health, software development, communications and health economics. 

Information and communication technologies have a demonstrated ability to reduce the burden of treatment for substance use disorders and HIV/AIDS, especially during continuing care. People with addictions and high risk for HIV tend to view the technologies favorably and acknowledge more drug use and psychiatric symptoms online than in face-to-face interviews.

Entitled "Implementing technology-assisted drug treatment and relapse prevention in FQHCs," the project will run through June 2017. "The first year and a half will be spent honing the software systems for the mobile devices, followed by three years of testing and refinement at three field sites," says Dhavan Shah, Maier-Bascom professor of journalism and mass communication and the scientific director of the grant.

The project responds to new demands being placed on an already overburdened health care system. FQHCs are being asked to integrate treatment for substance use disorders into primary care, adding a new, complex caseload to already overworked clinicians. The grant will be used to test a strategy of implementing a smartphone- and tablet-centered delivery system, composed of evidence-based treatment and relapse prevention programs, to relieve this burden and improve care. 

The system, called Seva (the Hindi word for selfless caring), will seamlessly combine cognitive behavioral therapy and mobile social support. Seva will include a therapeutic education system (TES), which employs cognitive behavioral therapies for addiction treatment, and a comprehensive health enhancement support system (CHESS), which uses a suite of mobile tools for relapse prevention, along with a population health registry for use by clinicians. TES also includes modules to prevent HIV, hepatitis, and sexually transmitted infections.