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We aimed to systematically review the effectiveness of remote interventions (delivered by telephone or computer) in alcohol\/drug treatment and recovery support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched 29 databases including Medline and PsycINFO for randomised controlled trials (RCTs) of remote interventions for adults diagnosed with alcohol\/drug use disorder conducted in Organization for Economic Co\u2010operation and Development (OECD) countries published 2004\u20132023. We grouped interventions according to whether they supplemented or replaced\/partially replaced in\u2010person care. We used random effects meta\u2010analyses to estimate pooled odds ratios (OR) for relapse, and standardised mean differences (SMD) for days of alcohol\/drug use. We appraised outcomes using Cochrane Risk of Bias 2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 34 RCTs (6461 participants) evaluating 42 remote interventions, with diverse therapeutic approaches. Over 70% of outcomes were judged to be at high risk\u2010of\u2010bias. When remote interventions supplemented in\u2010person care, there was a 39% lower odds of relapse [17 interventions; OR 0.61; 95% confidence interval (CI) = 0.46, 0.81; <jats:italic>P<\/jats:italic>\u2009=\u20090.001; I<jats:sup>2<\/jats:sup>\u00a0=\u200940.3%) and a reduction in the mean days of use (17 interventions; SMD \u22120.18; 95% CI = \u22120.28 to \u22120.08; <jats:italic>P<\/jats:italic>\u2009=\u20090.001; I<jats:sup>2<\/jats:sup>\u00a0=\u200927.3%) compared with in\u2010person care alone. When remote interventions replaced\/partially replaced in\u2010person care, there was a 49% lower odds of relapse (7 interventions; OR 0.51; 95% CI = 0.34, 0.76; <jats:italic>P<\/jats:italic>\u2009=\u20090.001; I<jats:sup>2<\/jats:sup>\u00a0=\u200939.7%) and a very slight and uncertain reduction in mean days of use (8 interventions; SMD \u22120.08; 95% CI = \u22120.24 to 0.07; <jats:italic>P<\/jats:italic>\u2009=\u20090.301; I<jats:sup>2<\/jats:sup>\u00a0=\u200948.4%) compared with in\u2010person care. Subgroup analyses by type of substance and therapeutic approach were mixed and inconclusive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Remote interventions which supplement in\u2010person alcohol\/drug treatment appear to reduce relapse and days of use. The evidence is less conclusive regarding remote interventions that replace\/partially replace in\u2010person care due to a smaller body of evidence and uncertainty (days of use). High risk\u2010of\u2010bias means findings should be interpreted with caution.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.70021","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T01:24:06Z","timestamp":1743038646000},"page":"1531-1550","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["How effective are remote and\/or digital interventions as part of alcohol and drug treatment and recovery support? 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