Burchett, H and Stansfield, Claire and Macdowall, W and Richardson, M and Dick, S and Dickson, Kelly and D’Souza, P and Khouja, Claire and Kwan, Irene and Raine, Gary and Sowden, Amanda and Sutcliffe, Katy and Thomas, J (2022) Digital interventions for alcohol and drug misuse prevention, treatment and recovery: systematic maps of research and available interventions. London: EPPI Centre, Social Science Research Unit, UCL Social Research Institute, University College London.
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What do we want to know?
Digital interventions can play a number of different roles to support behaviour change in the prevention, treatment of and recovery from alcohol and drug misuse. We wanted to know:
1) What is the possible range of digital alcohol and drug interventions?
2) Which types of interactive digital alcohol and drug interventions are currently available for use by service users and individuals in England?
3) What systematic reviews provide findings for digital alcohol and drug interventions at each point along the prevention/treatment/recovery pathway?
4) Which types of digital alcohol and drug interventions have been evaluated in primary research?
Who wants to know?
The findings are of use to policymakers, practitioners and researchers in commissioning, developing and recommending digital interventions for alcohol and drug misuse. The evidence maps and the related report were commissioned by the National Institute for Health Research (NIHR) Policy Research Programme (PRP) for the Department of Health and Social Care (DHSC) and Public Health England (PHE).
What did we find?
1) What is the possible range of digital alcohol and drug interventions?
An alcohol and drug pathway was conceptualised, which consists of three stages; prevention and early intervention, treatment and recovery, and sustaining recovery. Within each of the pathway points specific intervention types, relevant to that point, are presented. Peer support and overdose prevention were considered intervention types relevant at any point in the whole pathway.
2) Which types of interactive digital alcohol and drug interventions are currently available for use by service users and individuals in England?
We identified 40 interventions available for use in England, of which 26 focus on alcohol misuse, six on drug misuse and eight on either alcohol and drugs or unspecified substance misuse. Many interventions address multiple points in the pathway but the majority (n=35) are for prevention and early intervention, five are for treatment and recovery and nine relate to sustaining recovery. Nine include peer support and one has an overdose prevention component (some interventions cover more than one of these categories).
3) What systematic reviews provide findings for digital alcohol and drug interventions at each point along the prevention/treatment/recovery pathway?
We identified 18 systematic reviews that were published in or since 2014 and contained syntheses of findings relating to a specific point in the pathway of prevention, treatment and recovery. We rated four of these as high quality, seven as moderate quality and seven as low quality. Eleven reviews focus on alcohol-misuse only, one focuses on drug misuse only, the remaining six focus on alcohol and drug misuse or unspecified substance misuse. All 18 reviews explore prevention and early interventions, and one also concerns treatment and recovery. No reviews were identified that focus on sustaining recovery, peer support or overdose prevention.
4) Which types of digital drug and alcohol interventions have been evaluated in primary research?
1247 reports of primary studies evaluating interventions were identified, dated from 2004 onwards. The majority assess interventions targeting alcohol misuse (n=769), followed by drug misuse (n=226), and alcohol and drug or unspecified substance misuse (n=252). The majority of studies assessed prevention and early intervention (n=929), followed by treatment and recovery (n=222) and sustaining recovery (n=90), and 81 concern peer support (some could include more than one of these categories).
What are the implications?
Our findings show that there is much interest in digital interventions for alcohol and drug misuse but there are also some significant gaps in knowledge and practice. Of the many digital interventions available for use in England most are for alcohol misuse; there are fewer for drug or substance misuse. Most of these interventions focus on prevention and early intervention; there are particularly few focused on treatment and recovery or overdose prevention. Similarly most of the systematic reviews focus on alcohol and all focus on prevention and early intervention; there is a lack of review-level evidence for all other stages of the pathway. Primary studies also reflect this emphasis on alcohol misuse and prevention and early intervention.
How did we get these results?
To describe the possible range of interventions PHE developed a ‘pathway’, in liaison with the study team. This sets out the different stages at which interventions may be helpful, as well as the different types of intervention suited to addressing each stage.
To identify interventions available for use in England we conducted a survey with alcohol and drug commissioners, providers and intervention developers and evaluators. Interventions were also collected from stakeholders such as PHE and advisory group members.
To identify systematic reviews and primary studies we conducted systematic literature searches. We manually screened 14,387 research citations obtained from searches of 29 bibliographic databases and specialist resources during March 2019. The quality of the systematic reviews was appraised and detailed information extracted from reports. The primary study citations were assessed by their titles and abstracts only and were not quality appraised.
We developed two interactive online maps – one of systematic reviews and interventions available in England and one of primary studies evaluating interventions. Links to these maps are on the left side of this page, alongside the report that describes the methods and detailed findings of the maps. Further information on using the map and citing the maps can be found in each individual map.
B Substances > Substances in general
B Substances > Alcohol
HJ Treatment or recovery method > Substance disorder treatment method
J Health care, prevention, harm reduction and treatment > Substance use prevention > Targeted prevention
J Health care, prevention, harm reduction and treatment > Prevention approach
N Communication, information and education > Telehealth / Telemedicine / mHealth / eHealth
N Communication, information and education > Digital technology
VA Geographic area > International
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