title: Non-adherence to telemedicine interventions for drug users: systematic review.
abstract: OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably, depending on the country, the intervention method, follow-up time and substances used. Using more than one technique of intervention, short duration of treatment and the type of substance used by patients appear to facilitate adherence.
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Taís de Campos
authors.initials: Tde C
authors.lastname: Moreira
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Luciana
authors.initials: L
authors.lastname: Signor
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Luciana Rizzieri
authors.initials: LR
authors.lastname: Figueiró
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Simone
authors.initials: S
authors.lastname: Fernandes
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Cassandra Borges
authors.initials: CB
authors.lastname: Bortolon
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Mariana Canellas
authors.initials: MC
authors.lastname: Benchaya
authors.affiliation: Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Maristela
authors.initials: M
authors.lastname: Ferigolo
authors.affiliation: Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Helena Mt
authors.initials: HM
authors.lastname: Barros
mesh_terms: D001938:Brazil; D055030:Drug Users / Q000706:statistics & numerical data*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D019966:Substance-Related Disorders / Q000628:therapy*; D017216:Telemedicine / Q000706:statistics & numerical data*; D016903:Drug Monitoring