Acceptability of VloV, a Mobile App Developed in Latin America for People with Substance Use Disorder among an Intensive Outpatient Treatment

Abstract

Background: Digital therapeutic tools seem to be helpful for substance use disorders (SUD), but there are few studies in Latin America about this approach. Our group of therapists developed VloV (an abbreviation for Pavlovsky), a mobile app that attempts to digitize practical tools along with strengthening the therapeutic alliance and user practice. Method: We conducted a mixed-method pilot study between August 2021 and January 2022 to collect data about the patient experience using VloV and the therapeutic alliance among 23 patients. VloV is a Spanish mobile app available for free that focuses on SUD and covers therapeutic elements and tools from an intensive outpatient treatment program. A monthly PDF report containing the patient's daily interactions is generated and can be shared via e-mail with the therapist for follow-up. We run three questionnaires (Q), Q1 regarding technology use indications Q2 to review content information and the utility of the different elements of VloV, and Q3 to collect qualitative data about participants' experiences and perceptions. Several aspects of the therapeutic alliance were evaluated using the patient version of the Working Alliance Inventory in its short version (WAI-S-P). Several aspects of the therapeutic alliance were assessed using the patient version of the Working Alliance Inventory in its short version (WAI-S-P). The level of agreement between the raters—provider and monthly VloV reports—was calculated for treatment variables in patients and their mood state records. For some sub-analysis, patients were divided into two categories, those who have a daily app's use and those who have a weekly or sporadic use. Results: Patient characteristics were similar to the statistics of the treatment center data, including the dropout rate; only 15 out of 23 (65.2%) patients completed the 12 weeks of the pilot study. Participants reported daily use of the technology, but only 5.0% searched for health topic information on the web. Patients expressed positive feedback by using the app and found some functional aspects in VloV that contributed to their treatments and self-care as mood scale record, money earned display, sobriety calculator, and treatment skill functions. However, the “red button” function, which allows the patient to ask for help, was not found to be of much use. We found a correlation between the frequency app's use and a higher accuracy in the provider register of treatment related to variables. Although working alliance therapeutic scores were mainly high and non-differences were found. Conclusion: This is the first study on a mobile application for SUD developed in our region, and although it is only a preliminary study, it pointed out important lessons about incorporating digital therapeutic tools into mental health treatment in an intensive outpatient treatments (IOT) setting. Clinical Trial Registration: Sistema Integrado de Información Sanitaria Argentino (IS004799).