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Mobile App-Delivered Cognitive Behavioral Therapy for Insomnia: Feasibility and Initial Efficacy Among Veterans With Cannabis Use Disorders.

Babson KA, Ramo DE, Baldini L, Vandrey R, Bonn-Miller MO - JMIR Res Protoc (2015)

Bottom Line: Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future.The mood app was rated as not helpful, and there was low likelihood of future participation.This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence.

View Article: PubMed Central - HTML - PubMed

Affiliation: National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, United States. kimberly.babson@gmail.com.

ABSTRACT

Background: Cannabis is the most frequently used illicit substance in the United States resulting in high rates of cannabis use disorders. Current treatments for cannabis use are often met with high rates of lapse/relapse, tied to (1) behavioral health factors that impact cannabis use such as poor sleep, and (2) access, stigma, supply, and cost of receiving a substance use intervention.

Objective: This pilot study examined the feasibility, usability, and changes in cannabis use and sleep difficulties following mobile phone-delivered Cognitive Behavioral Therapy for Insomnia (CBT-I) in the context of a cannabis cessation attempt.

Methods: Four male veterans with DSM-5 cannabis use disorder and sleep problems were randomized to receive a 2-week intervention: CBT-I Coach mobile app (n=2) or a placebo control (mood-tracking app) (n=2). Cannabis and sleep measures were assessed pre- and post-treatment. Participants also reported use and helpfulness of each app. Changes in sleep and cannabis use were evaluated for each participant individually.

Results: Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future. In addition, they reported decreased cannabis use and improved sleep efficiency; one also reported increased sleep quality. In contrast, one participant in the control group dropped out of the study, and the other used the app minimally and reported increased sleep quality but also increased cannabis use. The mood app was rated as not helpful, and there was low likelihood of future participation.

Conclusions: This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence. Positive ratings of the app and preliminary reports of reductions in cannabis use and improvements in sleep are both encouraging and support additional evaluation of this intervention.

No MeSH data available.


Related in: MedlinePlus

Quantity of cannabis use during each day of the 90-day (30-days for participant 1) baseline and 2-week follow-up periods for each participant, as measured by the MSHQ (Participant 1) and TLFB (Participants 2-4). Vertical dashed line indicates the cessation day for each participant. Because Participant 2 did not complete the follow-up assessment, his data are not presented. Horizontal gray solid lines represent mean cannabis use during the represented timeframe (baseline, 2-week follow-up).
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figure2: Quantity of cannabis use during each day of the 90-day (30-days for participant 1) baseline and 2-week follow-up periods for each participant, as measured by the MSHQ (Participant 1) and TLFB (Participants 2-4). Vertical dashed line indicates the cessation day for each participant. Because Participant 2 did not complete the follow-up assessment, his data are not presented. Horizontal gray solid lines represent mean cannabis use during the represented timeframe (baseline, 2-week follow-up).

Mentions: Participant 1 was a 42-year-old single Caucasian male veteran who met DSM-5 criteria for current cannabis use disorder and alcohol use disorder. Participant 1 was a non-smoker and did not meet criteria for any mood or anxiety disorders. He was a novice with mobile technology and did not own a smartphone. As noted in the Method section, the MSHQ was administered instead of the TLFB for this participant. Based on the number of reported days using cannabis during the prior month, coupled with the quantity reported, we were able to extrapolate this participant’s cannabis use during the 30 days prior to baseline (see Figure 2). From this, we were able to determine that the participant’s mean cannabis use for the 30 days preceding his baseline appointment was 0.40 (on the 0-8 visual scale [36]). In terms of baseline sleep, a total PSQI score of 9 was observed, with a notable impairment in sleep efficiency (ratio of time asleep to time spent in bed trying to sleep; 58%). He reported no use of medications (prescription or over-the-counter) for sleep.


Mobile App-Delivered Cognitive Behavioral Therapy for Insomnia: Feasibility and Initial Efficacy Among Veterans With Cannabis Use Disorders.

Babson KA, Ramo DE, Baldini L, Vandrey R, Bonn-Miller MO - JMIR Res Protoc (2015)

Quantity of cannabis use during each day of the 90-day (30-days for participant 1) baseline and 2-week follow-up periods for each participant, as measured by the MSHQ (Participant 1) and TLFB (Participants 2-4). Vertical dashed line indicates the cessation day for each participant. Because Participant 2 did not complete the follow-up assessment, his data are not presented. Horizontal gray solid lines represent mean cannabis use during the represented timeframe (baseline, 2-week follow-up).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4527004&req=5

figure2: Quantity of cannabis use during each day of the 90-day (30-days for participant 1) baseline and 2-week follow-up periods for each participant, as measured by the MSHQ (Participant 1) and TLFB (Participants 2-4). Vertical dashed line indicates the cessation day for each participant. Because Participant 2 did not complete the follow-up assessment, his data are not presented. Horizontal gray solid lines represent mean cannabis use during the represented timeframe (baseline, 2-week follow-up).
Mentions: Participant 1 was a 42-year-old single Caucasian male veteran who met DSM-5 criteria for current cannabis use disorder and alcohol use disorder. Participant 1 was a non-smoker and did not meet criteria for any mood or anxiety disorders. He was a novice with mobile technology and did not own a smartphone. As noted in the Method section, the MSHQ was administered instead of the TLFB for this participant. Based on the number of reported days using cannabis during the prior month, coupled with the quantity reported, we were able to extrapolate this participant’s cannabis use during the 30 days prior to baseline (see Figure 2). From this, we were able to determine that the participant’s mean cannabis use for the 30 days preceding his baseline appointment was 0.40 (on the 0-8 visual scale [36]). In terms of baseline sleep, a total PSQI score of 9 was observed, with a notable impairment in sleep efficiency (ratio of time asleep to time spent in bed trying to sleep; 58%). He reported no use of medications (prescription or over-the-counter) for sleep.

Bottom Line: Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future.The mood app was rated as not helpful, and there was low likelihood of future participation.This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence.

View Article: PubMed Central - HTML - PubMed

Affiliation: National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, United States. kimberly.babson@gmail.com.

ABSTRACT

Background: Cannabis is the most frequently used illicit substance in the United States resulting in high rates of cannabis use disorders. Current treatments for cannabis use are often met with high rates of lapse/relapse, tied to (1) behavioral health factors that impact cannabis use such as poor sleep, and (2) access, stigma, supply, and cost of receiving a substance use intervention.

Objective: This pilot study examined the feasibility, usability, and changes in cannabis use and sleep difficulties following mobile phone-delivered Cognitive Behavioral Therapy for Insomnia (CBT-I) in the context of a cannabis cessation attempt.

Methods: Four male veterans with DSM-5 cannabis use disorder and sleep problems were randomized to receive a 2-week intervention: CBT-I Coach mobile app (n=2) or a placebo control (mood-tracking app) (n=2). Cannabis and sleep measures were assessed pre- and post-treatment. Participants also reported use and helpfulness of each app. Changes in sleep and cannabis use were evaluated for each participant individually.

Results: Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future. In addition, they reported decreased cannabis use and improved sleep efficiency; one also reported increased sleep quality. In contrast, one participant in the control group dropped out of the study, and the other used the app minimally and reported increased sleep quality but also increased cannabis use. The mood app was rated as not helpful, and there was low likelihood of future participation.

Conclusions: This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence. Positive ratings of the app and preliminary reports of reductions in cannabis use and improvements in sleep are both encouraging and support additional evaluation of this intervention.

No MeSH data available.


Related in: MedlinePlus