MindTech researchers have published their latest review of evidence in the field of digitally delivered, remote therapy for tic disorders.
Tic disorders, such as Tourette syndrome (TS), affect around 1% of children and around 0.05% of adults and are associated with a range of co-occurring behavioural, motor, and emotional conditions which can have a profound impact on children's and adult's quality of life, school/work experience and peer relationships.
Although pharmacological interventions can be useful for people with tic disorders, behavioural and educational approaches are generally recommended in guidelines as a first line intervention. However, access to evidence-based behavioural therapies is limited due to the small number of highly trained therapists based in a few specialist centres with an uneven geographical distribution of services relative to demand.
The rapid expansion of, access to, and engagement with digital technology over the past 15 years has transformed the potential for remote delivery of evidence-based digital health interventions (DHIs). Digital and remote behavioural interventions have the potential to address current gaps in the provision of evidence-based therapies in healthcare services. As the lack of access to behavioural treatments for people with tic disorders is a pressing issue across the world, there is great potential for DHIs to close this treatment gap.
In this latest paper, our researchers present a critical synthesis of the recent key advances in the field of digitally delivered, remote therapy for tics, outlining the research evidence for the clinical and cost-effectiveness and acceptability of digital or remotely delivered therapy.
The evidence supports using DHIs to deliver tic therapies, which also show good adherence and engagement and are acceptable to patients. Despite utilizing randomized controlled trials, only two trials were sufficiently powered to address efficacy and only one trial explored contextual factors that may influence engagement.
Moreover, only one trial followed patients for >12 months, thus further long-term follow-ups are required. Specifically, we note that despite an emerging evidence base, DHIs for tics are yet to be routinely implemented in healthcare provision in any country. Drawing on the existing evidence, a stepped care model is proposed, in which digital therapy is implemented as a widely accessible first-line treatment using a purely online or therapist-supported approach.
The review can be found in full in Frontiers in Psychiatry.