Simone Fernandes

Brief Motivational Intervention and telemedicine: a new perspective of treatment to marijuana users.

The main purpose of this study was to evaluate the telephone Brief Motivational Intervention (BMI) efficacy in marijuana consumption cessation. A clinical trial was performed on Brazilian citizens, who were randomly divided into experimental (BMI) and minimal intervention (reference material) treatment groups; the study involved 524 participants who were monitored for 6 months. In addition, the data was collected by a free-service call center; both marijuana consumption and level of motivation for behavior change were evaluated, based on the telephone service offered. The proportion of abstainers in the BMI group was significantly greater than in the control group: 73% of the individuals in the BMI group were abstainers. In the control group, 59% of them ceased on using marijuana. The ratio of probability for marijuana cessation was 1.6 times higher in the BMI group. There was no significant difference on the motivation for behavior change in both groups. The collected data demonstrated the telephone BMIs positive efficacy in marijuana consumption cessation.

Quality of life of users of psychoactive substances, relatives, and non-users assessed using the WHOQOL-BREF

Quality of life is related to one of the basic human desires, which is to live well and feel good. The scope of this study was to evaluate the quality of life of psychoactive substance users and relatives, compared to non-users, analyzed by socioeconomic strata. A cross-sectional study with users of psychoactive substances, relatives, and other individuals who called the Information and Orientation Service regarding drug abuse. Data collection took place between November 2009 and December 2010. Data was collected from users, relatives, and non-users, including socioeconomic characteristics and data regarding substance consumption when appropriate. In addition to this the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was given to 347 individuals. Among the 138 users (70%) used alcohol, 76 (39%), marijuana, 111 (57%) tobacco, 78 (40%) cocaine and 70 (36%) crack. Control subjects had higher, scores than the relatives of users and users in all areas of the questionnaire (p < 0.05). Psychoactive substance users scored lower in almost all domains and overall score in the WHOQOL-BREF questionnaire in comparison with the sample of non-drug users. These findings reflect poor quality of life of patients and their relatives.

Efficacy of the telephone-based Brief Motivational Intervention for alcohol problems in Brazil

BACKGROUND The Brief Motivational Intervention (BMI) is an effective treatment for alcohol misuse but has not been adequately tested for use in helplines for alcoholics. The main objective of this study was to evaluate the efficacy of a telephone-based BMI for Brazilians seeking help with alcohol use cessation. METHODS A randomized, controlled trial was performed with Brazilian subjects. Participants were randomly assigned to either the minimal intervention group (i.e., given reference materials) or the BMI group. Alcohol abstinence was evaluated in a 6-month follow-up telephone counseling session. The analysis was based on the intention to treat (ITT). RESULTS Of the 5,896 drug users who called the helpline, 700 (12%) used alcohol, 637 of whom enrolled in this study. At 6-month follow-up, 70% of the BMI group had stopped consuming alcohol compared to 41% in the control group (odds ratio = 1.5; 95% confidence interval = 1.2-1.9; p = 0.001). CONCLUSIONS A helpline-based BMI helps alcohol users achieve abstinence.

A eficácia das intervenções farmacológicas e psicossociais para o tratamento do tabagismo: revisão da literatura

Efficacy of pharmacological and no-pharmacological treatments for smoking cessation. Smoking cessation is associated to health benefits, because individuals who stop smoking will avoid most tobacco-related disorders. Our aim was to review the most important characteristics and the efficacy of the pharmacological and psychossocial treatments available for tobacco smokers, presenting meta-analysis and randomized clinical trials fundamental conclusions. Pharmacological interventions involving nicotine replacement and antidepressant use, with bupropion as the first line agent, and psychossocial interventions involving cognitive behavioral therapies and face-to-face or phone-based motivational interventions are proving to be efficacious. Pharmacotherapies increase two-fold the chance of abstinence and face-to-face or phonebased psychosocial interventions increase the chance of quitting smoking in 1.5 to 2.5 times in comparison to individuals who try to quit smoking by themselves. These data support health professionals to decide the most effective treatment for individual smokers, according to the available interventions tested, their efficacy and the benefits of use.

Perfil dos usuários do serviço de teleatendimento sobre drogas de abuso VIVAVOZ

INTRODUCTION: Drug abuse is a major public health problem. Telephone interventions have been used as a treatment method. This study aimed at describing the sociodemographic profile, consumption pattern and dependence on psychoactive substances of individuals seeking help in a telephone service on drugs of abuse. METHODS: Data were collected by previously trained consultants using an electronic protocol throughout the first year of the service. Instruments were applied to find the sociodemographic profile, consumption pattern and dependence of drug users. Descriptive statistics was used to estimate distribution of variables, and the data are presented as frequencies. RESULTS: Throughout the study period there were 28,257 calls, of which 7,956 were included. In total there was higher prevalence of women, students, single individuals, older than 35 years, with incomplete primary education and family income lower than five minimum wages. Men aged 18-25 years were prevalent in the sample. The most frequently used drugs were tobacco, cannabis, alcohol and cocaine. Tobacco use was similar for both genders. Males used more illicit drugs. Most drug users were dependent, and men had higher rates of addiction to tobacco and solvents. CONCLUSIONS: These results outline the profile of individuals who seek care through a telephone service, showing the importance of these services for the population and guiding preventive actions.

Non-adherence to telemedicine interventions for drug users: systematic review

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.