Revisión sistemática de intervenciones digitales para la reducción del consumo de cannabis
Contenido principal del artículo
Resumen
Introducción: la cannabis es una de las drogas que más se consume en el mundo y por la que hay mayor demanda de tratamiento. Los usuarios han identificado dificultades para acceder a tratamientos tradicionales, entre ellas el transporte, los costos y el estigma social. En el ámbito de la salud existen intervenciones digitales que usan la tecnología para facilitar la implementación de tratamientos; algunas se enfocan en la reducción del consumo de drogas, específicamente de cannabis; éstas podrían contribuir a solventar la demanda de tratamiento y a reducir las dificultades reportadas por los usuarios.
Objetivo: actualizar el conocimiento acerca de la efectividad de las intervenciones digitales para reducir el consumo de cannabis, a través de una revisión sistemática.
Método: en octubre de 2017 se emprendió una búsqueda sistemática en las siguientes fuentes: Cochrane Central Register of Controlled Trials, PsycINFO y PubMed; el intervalo de búsqueda fue 2010-2017.
Resultados: fueron identificados 1022 registros, de los cuales se eligieron 26 ensayos clínicos para su análisis en la presente revisión.
Discusión: la mitad de los ensayos analizados reportaron reducción en el consumo de cannabis asociado con una intervención digital. Hay algunas características frecuentes en las intervenciones; por ejemplo, la mayoría usa Internet para su entrega, se emplea la entrevista motivacional como enfoque teórico y gran parte de ellas se realizan en una única sesión. Ninguna de estos atributos u otro fue constante en las intervenciones efectivas.
Conclusiones: existen intervenciones digitales efectivas para la reducción del consumo de cannabis. Se requiere mayor investigación para determinar las características que comprueban su efectividad, especialmente las que son propias de su condición digital.
Detalles del artículo
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
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Balhara, Y. P. S., & Verma, R. (2014). A review of web based interventions focusing on alcohol use. Annals of Medical and Health Sciences Research, 4(4), 472-480. doi: 10.4103/2141-9248.139272
Balhara, Y. P. S., & Verma, R. (2014b). A review of web based interventions for managing tobacco use. Indian Journal of Psychological Medicine, 36(3), 226-235. doi: 10.4103/0253-7176.135367
Barak, A., Klein, B., & Proudfoot, J. G. (2009). Defining Internet-supported therapeutic interventions. Annals of Behavioral Medicine, 38(1), 4-17. doi: 10.1007/s12160-009-9130-7.
Becker, J., Haug, S., Sullivan, R., & Schaub, M. P. (2014). Effectiveness of different web-based interventions to prepare co-smokers of cigarettes and cannabis for double cessation: a three-arm randomized controlled trial. Journal of Medical Internet Research, 16(12), e273. doi: 10.2196/jmir.3246
Becoña, I. E., Cortés, T. M. T., Pedrero, P. E. J., Fernández, H. J. R., Casete, F. L., Bermejo, G. M. P., … Tomás, G. V. (2008). Guía clínica de intervención psicológica en adicciones. Barcelona: Socidrogalcohol.
Blow, F., Bohnert, A. S., Ignacio, R., Barry, K., Ilgen, M. A., Booth, B. M.,… Walton, M. (2015). Efficacy of computer and therapist brief interventions for drug users. Drug and Alcohol Dependence, 156(1-2), 74-79. doi: 10.1016/j.drugalcdep.2015.07.975
Budney, A. J., Stanger, C., Tilford, J. M., Scherer, E., Brown, P. C., Li, Z., … Walker, D. (2015). Computer-assisted behavioral therapy and contingency management for cannabis use disorder. Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors, 29(3), 501–511. doi: 10.1037/adb0000078
Centro Cochrane Iberoamericano, (2012). Manual Cochrane de Revisiones Sistemáticas de Intervenciones versión 5.1.0 (actualizada en marzo de 2011). Barcelona: Autor. Recuperado de http://www.cochrane.es/?q=es/node/269
Champion, K. E., Newton, N. C., Stapinski, L., Slade, T., Barrett, E. L., & Teesson, M. (2016). A cross-validation trial of an Internet-based prevention program for alcohol and cannabis: preliminary results from a cluster randomised controlled trial. Australian & New Zealand Journal of Psychiatry, 50(1), 64-73. doi: 10.1177/0004867415577435
Christensen, H., Griffiths, K. M., & Korten, A. (2002). Web-based cognitive behavior therapy: analysis of site usage and changes in depression and anxiety scores. Journal of Medical Internet Research, 4(1), e3.
Clarke, A. M., Kuosmanen, T., & Barry, M. M. (2015). A systematic review of online youth mental health promotion and prevention interventions. Journal of Youth and Adolescence, 44(1), 90-113. doi: 10.1007/s10964-014-0165-0.
Cochran, G., Stitzer, M., Campbell, A. N., Hu, M. C., Vandrey, R., & Nunes, E. V. (2015). Web-based treatment for substance use disorders: differential effects by primary substance. Addictive Behaviors, 45, 191-194. doi: 10.1016/j.addbeh.2015.02.002
Elliott, J. C., Carey, K. B., & Vanable, P. A. (2014). A preliminary evaluation of a web-based intervention for college marijuana use. Psychology of Addictive Behaviors, 28(1), 288. doi oi:10.1037/a0034995
European Monitoring Center for Drugs and Drug Addiction. (2015). Annual report: the state of the drugs problem in Europe. Lisbon, Luxembourg: Publications Office of the European Union. doi: 10.2810/084165
European Monitoring Centre for Drugs and Drug Addiction. (2015b). Treatment of cannabis-related disorders in Europe. Luxembourg: Publications Office of the European Union. doi: 10.2810/621856
Fang, L., Schinke, S. P., Steven, P. (2013). Two-year outcomes of a randomized, family-based substance use prevention trial for Asian American adolescent girls. Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors, 27(3), 788-798. doi: 10.1037/a0030925
Gill, H. K., Gill, N., & Young, S. D. (2013). Online technologies for health information and education: a literature review. Journal of Consumer Health on the Internet, 17(2), 139-150. doi: 10.1080/15398285.2013.780542
Gold, J., Pedrana, A. E., Sacks-Davis, R., Hellard, M. E., Chang, S., Howard, S., … Stoove, M. A. (2011). A systematic examination of the use of online social networking sites for sexual health promotion. BMC Public Health, 11(1), 583. doi: 10.1186/1471-2458-11-583
Gryczynski, J., Mitchell, S. G., Gonzales, A., Moseley, A., Peterson, T. R., Ondersma, S. J., … Schwartz, R. P. (2015). A randomized trial of computerized vs. in-person brief intervention for illicit drug use in primary care: outcomes through 12 months. Journal of Substance Abuse Treatment, 50, 3-10. doi: 10.1016/j.jsat.2014.09.002
Gryczynski, J., O’Grady, K. E., Schwartz, R. P., Mitchell, S. G., & Ondersma, S. J. (2016). Immediate versus delayed computerized brief intervention for illicit drug misuse. Journal of Addiction Medicine, 10(5), 344-351.
Hoch, E., Preuss, U. W., Ferri, M., & Simon, R. (2016). Digital interventions for problematic cannabis users in non-clinical settings: findings from a systematic review and meta-analysis. European Addiction Research, 22(5), 233-242. doi: 10.1159/000445716
Jonas, B., Tossmann, P., Tensil, M., Leuschner, F., & Struber, E. (2012). Efficacy of a single-session online-intervention on problematic substance use. Sucht, 58, 173-182. doi: 10.1024/0939-5911.a000182
Jones, J., & Salazar, L. F. (2016). A review of HIV prevention studies that use social networking sites: implications for recruitment, health promotion campaigns, and efficacy trials. AIDS and behavior, 20(11), 2772-2781. doi: 10.1007/s10461-016-1342-9
Kay-Lambkin, F. J., Baker, A. L., Kelly, B., & Lewin, T. J. (2011). Clinician-assisted computerized versus therapist-delivered treatment for depressive and addictive disorders: Aarandomized controlled trial. Medical Journal of Australia, 195(3), 44-50.
Lee, C. M., Neighbors, C., Kilmer, J. R., & Larimer, M. E. (2010). A brief, web-based personalized feedback selective intervention for college student marijuana use: a randomized clinical trial. Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors, 24(2), 265-273. doi: 10.1037/a0018859
Leeman, R. F., Pérez, E., Nogueira, C., & DeMartini, K. S. (2015). Very-brief, web-based interventions for reducing alcohol use and related problems among college students: a review. Frontiers in P|sychiatry, 6 (129). doi: 10.3389/fpsyt.2015.00129
Lehto, T., & Oinas-Kukkonen, H. (2011). Persuasive features in web-based alcohol and smoking interventions: a systematic review of the literature. Journal of Medical Internet Research, 1(3), e46. doi: 10.2196/jmir.1559
Litvin, E. B., Abrantes, A. M., & Brown, R. A. (2013). Computer and mobile technology-based interventions for substance use disorders: an organizing framework. Addictive Behaviors, 38(3), 1747-1756.
Malmberg, M., Kleinjan, M., Overbeek, G., Vermulst, A., Monshouwer, K., Lammers, J., ... Engels, R. C. (2014). Effectiveness of the ‘Healthy School and Drugs’ prevention programme on adolescents’ substance use: a randomized clustered trial. Addiction, 109(6), 1031-1040. doi: 10.1111/add.12526
Newton, N. C., Teesson, M., Vogl, L. E., & Andrews, G. (2010). Internet‐based prevention for alcohol and cannabis use: final results of the Climate Schools course. Addiction, 105(4), 749-759. doi: 10.1111/j.1360-0443.2009.02853.x
Nordic Cochrane Centre Review Manager. (2014). RevMan (Computer program) Version 5.3. Copenhagen: The Cochrane Collaboration.
Oficina de las Naciones Unidas contra la Droga y el Delito (2013). Informe Mundial sobre las Drogas 2013. Recuperado de https://www.unodc.org/doc/wdr2013/World_Drug_Report_2013_Spanish.pdf
Oficina de las Naciones Unidas contra la Droga y el Delito. (2017). Informe Mundial sobre las Drogas 2017. Recuperado de https://www.unodc.org/doc/wdr2016/WDR_2016_ExSum_spanish.pdf
Ondersma, S. J., Svikis, D., Thacker, L., Beatty, J. R., & Lockhart, N. (2014). Computer-delivered screening and brief intervention (e-SBI) for postpartum drug use: a randomized trial. Journal of Substance Abuse Treatment, 46(1), 52-59. doi: 10.1016/j.jsat.2013.07.013
Palfai, T. P., Saitz, R., Winter, M., Brown, T. A., Kypri, K., Goodness, T. M., … Lu, J. (2014). Web-based screening and brief intervention for student marijuana use in a university health center: pilot study to examine the implementation of eCHECKUP TO GO in different contexts. Addictive Behaviors, 39(9), 1346-1352. doi: 10.1016/j.addbeh.2014.04.025
Riper, H., Spek, V., Boon, B., Conijn, B., Kramer, J., Martin-Abello, K., … Smit, F. (2011). Effectiveness of E-self-help interventions for curbing adult problem drinking: a meta-analysis. Journal of Medical Internet Research, 13(2), e42. doi: 10.2196/jmir.1691
Rooke, S., Copeland, J., Norberg, M., Hine, D., & McCambridge, J., (2013). Effectiveness of a self-guided web-based cannabis treatment program: randomized controlled trial. Journal of Medical Internet Research, 15(2), e26. doi: 10.2196/jmir.2256
Rooke, S., Webb, L., Albertella, L., & Copeland, J., (2015). A smartphone application for managing cannabis use. Drug and Alcohol Dependence, 156, e192. doi: 10.1016/j.drugalcdep.2015.07.516
Schaub, M. P., Wenger, A., Berg, O., Beck, T., Stark, L., Buehler, E., … Haug, S. (2015). A web-based self-help intervention with and without chat counseling to reduce cannabis use in problematic cannabis users: three-arm randomized controlled trial. Journal of Medical Internet Research, 17(10), e232. doi: 10.2196/jmir.4860
Schinke, S. P., Fang, L., & Cole, K. C. A. (2011). Preventing substance abuse among black and hispanic adolescent girls: results from a computer-delivered, mother-daughter intervention approach. Substance Use & Misuse, 46(1), 35-45. doi: 10.3109/10826084.2011.521074
Schwinn, T. M., Schinke, S. P., & Di Noia, J. (2010). preventing drug abuse among adolescent girls: outcome data from an internet-based intervention. Prevention Science: The Official Journal of the Society for Prevention Research, 11(1), 24. doi: 10.1007/s11121-009-0146-9
Schwinn, T. M., Schinke, S. P., Hopkins, J., Keller, B., & Liu, X. (2017). An online drug abuse prevention program for adolescent girls: posttest and 1-year outcomes. Journal of Youth and Adolescence, 47(3), 490-500. doi: 10.1007/s10964-017-0714-4
Shingleton, R. M., & Palfai, T. P. (2016). Technology-delivered adaptations of motivational interviewing for health-related behaviors: a systematic review of the current research. Patient Education and Counseling, 99(1), 17-35. doi: 10.1016/j.pec.2015.08.005
Strecher, V. (2007). Internet methods for delivering behavioral and health-related interventions (eHealth). Annual Review of Clinical Psychology, 3, 53-76. doi: 10.1146/annurev.clinpsy.3.022806.091428
Substance Abuse and Mental Health Services Administration. (2012). Results from the 2011 National Survey on Drug Use and Health: summary of national findings (NSDUH Series H-44, HHS Publication No. 12-4713). Recuperado de https://www.samhsa.gov/data/sites/default/files/Revised2k11NSDUHSummNatFindings/Revised2k11NSDUHSummNatFindings/NSDUHresults2011.htm
Tait, R. J., & Christensen, H. (2010). Internet-based interventions for young people with problematic substance use: a systematic review. Medical Journal of Australia, 192(11), S15.
Tait, R. J., McKetin, R., Kay-Lambkin, F., Carron-Arthur, B., Bennett, A., Bennett, K., … Griffiths, K. M. (2015). Six-month outcomes of a web-based intervention for users of amphetamine-type stimulants: randomized controlled trial. Journal of Medical Internet Research, 17(4), e105.
Tait, R. J., Spijkerman, R., & Riper, H. (2013). Internet and computer based interventions for cannabis use: a meta-analysis. Drug and Alcohol Dependence, 133(2), 295-304. doi: 10.1016/j.drugalcdep.2013.05.012
Tiburcio, M., Lara, M. A., Aguilar Abrego, A., Fernández, M., Martínez Vélez, N., & Sánchez, A. (2016). Web-based intervention to reduce substance abuse and depressive symptoms in Mexico: development and usability test. JMIR Mental Health, 3(3), e47. doi: 10.2196/mental.6001
Tossmann, D. H. P., Jonas, B., Tensil, M. D., Lang, P., & Strüber, E. (2011). A controlled trial of an Internet-based intervention program for cannabis users. Cyberpsychology, Behavior and Social Networking, 14(11), 673-679. doi: 10.1089/cyber.2010.0506.
Välimäki, M., Athanasopoulou, C., Lahti, M., & Adams, C. E. (2016). Effectiveness of social media interventions for people with schizophrenia: a systematic review and meta-analysis. Journal of Medical Internet Research, 18(4), e92. doi: 10.2196/jmir.5385
Vogl, L. E., Newton, N. C., Champion, K. E., & Teesson, M. (2014). A universal harm-minimisation approach to preventing psychostimulant and cannabis use in adolescents: a cluster randomised controlled trial. Substance Abuse Treatment, Prevention, and Policy, 9, 24. doi: 10.1186/1747-597X-9-24
Vona, P., Wilmoth, P., Jaycox, L. H., McMillen, J. S., Kataoka, S. H., Wong, M., … Stein, B. D. (2014). A web-based platform to support an evidence-based mental health intervention: lessons from the CBITS web site. Psychiatric Services, 65(11), 1381-1384. doi: 10.1176/appi.ps.201300512
Walton, M. A., Bohnert, K., Resko, S., Barry, K. T., Chermack, S. T., Zucker, R. A., … Blow, F. C. (2013). Computer and therapist based brief interventions among cannabis-using adolescents presenting to primary care: one year outcomes. Drug and Alcohol Dependence, 132(3), 646-653. doi: 10.1016/j.drugalcdep.2013.04.020
Walton, M. A., Resko, S., Barry, K. L., Chermack, S. T., Zucker, R. A., Zimmerman, M. A.,… Blow, F. C. (2014). A randomized controlled trial testing the efficacy of a brief cannabis universal prevention program among adolescents in primary care. Addiction, 109(5), 786-797. doi: 10.1111/add.12469