Link Between Perception of Treatment Need and Craving Reports in Addiction

Knowledge, attitude, and practice towards knee osteoarthritis: a regional study in Chinese patients

INTRODUCTION

Given the chronic nature of knee osteoarthritis and its reliance on self-management, patients' knowledge, attitudes, and practice (KAP) significantly influence their ability to effectively manage knee osteoarthritis. This study aimed to investigate patients' KAP towards knee osteoarthritis.

METHODS

This cross-sectional survey was conducted among patients with knee osteoarthritis, using a self-designed questionnaire.

RESULTS

A total of 764 (96.47%) valid questionnaires enrolled, including 451 (59.03%) females, with a mean age of 48.28 ± 7.08 years. Their mean KAP scores were 8.10 ± 3.67 (possible range 0-16), 26.40 ± 4.492 (possible range 9-45), and 20.67 ± 5.156 (possible range 7-35), respectively. Structural equation modelling showed that knowledge had direct effects on attitude and practice. Attitude was found to exert a direct impact on practice. Moreover, multivariate logistic regression showed that employment, family's monthly income, duration of knee osteoarthritis, and medication were independently associated with knowledge. Age, sex, employment, and coachfellow were independently associated with attitude. Sex, employment, and marital status were independently associated with practice (all P < 0.05).

CONCLUSION

Patients had inadequate knowledge, negative attitude, and inactive practice towards knee osteoarthritis. Age, gender, employment, and marital status, monthly income, duration of knee osteoarthritis, medication, and coachfellow might be associated with their KAP. It is recommended to enhance clinical practice through patient education, personalized exercise plans, and tailored care based on individual patient profiles for improved knee osteoarthritis management. Key Points • Patients show inadequate KAP towards knee osteoarthritis. • Factors affecting KAP include age, gender, and income. • Need for patient education and personalized care in management.

Physical Exercise to Redynamize Interoception in Substance use Disorders

Physical exercise is considered a promising medication-free and cost-effective adjunct treatment for substance use disorders (SUD). Nevertheless, evidence regarding the effectiveness of these interventions is currently limited, thereby signaling the need to better understand the mechanisms underlying their impact on SUD, in order to reframe and optimize them. Here we advance that physical exercise could be re-conceptualized as an "interoception booster", namely as a way to help people with SUD to better decode and interpret bodily-related signals associated with transient states of homeostatic imbalances that usually trigger consumption. We first discuss how mismatches between current and desired bodily states influence the formation of reward-seeking states in SUD, in light of the insular cortex brain networks. Next, we detail effort perception during physical exercise and discuss how it can be used as a relevant framework for re-dynamizing interoception in SUD. We conclude by providing perspectives and methodological considerations for applying the proposed approach to mixed-design neurocognitive research on SUD.

The Craving-Manager smartphone app designed to diagnose substance use/addictive disorders, and manage craving and individual predictors of relapse: a study protocol for a multicenter randomized controlled trial

Background

The rate of individuals with addiction who are currently treated are low, and this can be explained by barriers such as stigma, desire to cope alone, and difficulty to access treatment. These barriers could be overcome by mobile technologies. EMI (Ecological Momentary Intervention) is a treatment procedure characterized by the delivery of interventions (messages on smartphones) to people in their daily lives. EMI presents opportunities for treatments to be available to people during times and in situations when they are most needed. Craving is a strong predictor of relapse and a key target for addiction treatment. Studies using Ecological Momentary Assessment (EMA) method have revealed that, in daily life, person-specific cues could precipitate craving, that in turn, is associated with a higher probability to report substance use and relapse in the following hours. Assessment and management of these specific situations in daily life could help to decrease addictive use and avoid relapse. The Craving-Manager smartphone app has been designed to diagnose addictive disorders, and assess and manage craving as well as individual predictors of use/relapse. It delivers specific and individualized interventions (counseling messages) composed of evidence-based addiction treatments approaches (cognitive behavioral therapy and mindfulness). The Craving-Manager app can be used for any addiction (substance or behavior). The objective of this protocol is to evaluate the efficacy of the Craving-Manager app in decreasing use (of primary substance(s)/addictive behavior(s)) over 4 weeks, among individuals on a waiting list for outpatient addiction treatment.

Methods/design

This multicenter double-blind randomized controlled trial (RCT) will compare two parallel groups: experimental group (full interventional version of the app, 4 weeks, EMA + EMI), versus control group (restricted version of the app, 4 weeks, only EMA). Two hundred and seventy-four participants will be recruited in 6 addiction treatment centers in France.

Discussion

This RCT will provide indication on how the Craving-Manager app will reduce addictive use (e.g., better craving management, better stimulus control) in both substance and behavioral addictions. If its efficacy is confirmed, the app could offer the possibility of an easy to use and personalized intervention accessible to the greatest number of individuals with addiction.

Clinical Trial Registration

ClinicalTrials.gov: NCT04732676.