A recent randomised control trial gives support to the use of computer-based therapy for treatment of addictions. The results were reported this week at the annual convention of the Association for Psychological Science in San Francisco, following publication in the American Journal of Psychiatry. Although the trial focused specifically on cocaine-dependent individuals, it replicates findings of a RCT carried out in 2008, in which participants had a wider range of substance addictions.
Results of this latest study show that those who received computer-assisted therapy were significantly more likely to attain three or more consecutive weeks of abstinence from cocaine as compared to those not receiving any form of Cognitive Behavioural Therapy (CBT) – 36% compared with 17%. And the effects appear to last; the control group also had better outcomes six months after treatment had ended.
Individuals who receive CBT learn to identify and correct problematic behaviours by applying a range of techniques. Central elements of the therapy include anticipating likely problems, correcting harmful thought patterns, and developing effective coping strategies. The techniques enable people to counteract addiction’s powerful effects on the brain, so they can regain control of their behaviour and lives. (more…)
Editor Charles summarises the one day conference at the Royal Society of Medicine on 27th February
This was the first conference in 2014 organised by the Royal Society of Medicine’s Telemedicine & eHealth Section. The day began with one of Dr Kevin Doughty’s excellent presentations on telecare. Kevin is Deputy Director of CUHTec. One key message was that the oldest people in society – those most in need of support to remain in the community – were best communicated with using televisions. In response to this requirement he particularly picked out the Speakset set-top box as a low cost, easy-to-use add-on to make any television into a videoconferencing unit.
This was followed by an excellent summary by Julie Bretland, Director, OurMobileHealth, on the maturity of the use of mobile apps, in particular the need for good curation. (This subject will be explored in much greater detail in the RSM’s 10th April apps event, where there are still just a few places left.)
Next came (more…)
I have recently been made aware of an excellent publication jointly by the Royal Academy of Engineering and the Academy of Medical Sciences entitled Establishing high-level evidence for the safety and efficacy of medical devices and systems, so this post is to reach out to those like me who were previously unaware.
It is a major step forward in applying engineering methodology to evaluating the effectiveness of medical devices & systems and, even more important, ensuring their ongoing safety. Those of us who have participated in a substantial randomised control trial such as the Whole System Demonstrator (see earlier post today) will take great interest at what follows the quote: “For pharmaceutical innovation, the randomised controlled trial is the acknowledged gold standard for creating a body of high-quality evidence. But designing clinical trials to establish the evidence for medical devices has proven more problematic.”
(Included in the paper is the observation that the ultimate health improvement device when you leave an aeroplane that is in the air – the parachute – has never been proven by an RCT.)
Finally just to return to an earlier comment, the report makes the point that because medical devices can be changed far more often than the composition of a drug, the importance of appropriate safety monitoring is absolutely critical, an issue that is becoming increasingly relevant as penetration of telehealth (in particular) and telecare increases. Whilst we might choose to ignore the different nature of medical devices when assessing a trial, we cannot ignore the different nature of medical devices when designing and putting in place appropriate safety systems.