Reward-based Technology to Improve OUD Treatment

Last updated: June 27, 2024
Sponsor: Q2i, LLC
Overall Status: Active - Recruiting

Phase

N/A

Condition

Opioid Use Disorder

Stimulant Use Disorder

Treatment

MyMAT Software Application

OARSCM Software Application

Clinical Study ID

NCT05180669
H00017879-2
R42DA049448
  • Ages > 18
  • All Genders

Study Summary

Millions of people in the US misuse opioids each year, leading to thousands of deaths and costing billions of dollars in total economic burden. Medication assisted treatment (MAT) for opioid use disorder (OUD) is highly efficacious, but only a fraction of OUD persons access MAT, and treatment non-adherence is common and associated with poor outcomes. This STTR Fast Track proposal is designed to increase rates of Suboxone (buprenorphine/naloxone) treatment initiation and adherence among OUD patients recruited from emergency and inpatient acute care. To accomplish these aims, the project will enhance the Opioid Addiction Recovery Support (OARS), an existing Q2i company technology, with a new evidence-based reward, contingency management (CM) function. CM interventions systematically reward (reinforce) specific behaviors like treatment initiation and adherence with therapy attendance and drug-free urine tests and are highly efficacious. An OARS solution enhanced with a CM component (OARSCM) that allows for the automatic calculation, delivery, and redemption of rewards contingent on objective evidence of treatment behaviors may be key to improving Suboxone initiation and adherence. In Phase 1 of this proposal, the existing OARS clinician portal and patient mobile application will be modified to accommodate entry into the software system from an acute care setting and to automatically manage and deliver rewards to create OARSCM using patient-centered design principles. Focus groups with OUD patients and other key stakeholders will inform design. Primary usability outcomes will be examined, and the program iteratively updated. After meeting milestones, there was a proof-of-concept pilot of usability, acceptability, and effects on initial behavior targets with approximately 20 patients and at least 4 providers. After meeting milestones, this RCT will follow, in which acute care OUD patients appropriate for outpatient Suboxone (N = 102) are recruited and allocated to one of two study conditions: 1) treatment as usual (TAU) with MyMAT, comprised of screening, brief intervention, referral to treatment by a trained clinician, and an educational mobile app (MyMAT), 2) OARSCM. The active intervention window for the two intervention groups will be 12 weeks. Patients will be onboarded prior to discharge from acute care. In the outpatient Suboxone setting, data on treatment adherence and opioid use will be captured from clinical records for six months. Telephone follow-up assessments and vital statics registry reviews will be at month 1, month 3 (end-of-study intervention period), and month 6. Primary Suboxone treatment initiation outcomes will be completing the Suboxone intake. Primary Suboxone treatment outcomes will be sustained abstinence at Month 6 and longest duration of abstinence. Analysis will examine data on cost avoidance and cost savings through reduced acute care visits between study conditions.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. >= 18 years old

  2. Presenting for acute care at UMass University and Memorial hospitals, including EDs,inpatient medical units, or inpatient behavioral health units for opioid addictionrelated health complaints, including opioid overdose, opioid related medicalconsequences, opioid intoxication or withdrawal syndromes, and/or seeking help forOUD

  3. Presence of a current DSM-V opioid use disorder (OUD), mild to severe

  4. Medically appropriate for outpatient Suboxone treatment, as judged by the treatingclinician and behavioral health consultant or toxicologist working with the patientclinically

Exclusion

Exclusion Criteria:

  1. Persistent altered mental status (not alert, not oriented, psychotic).

  2. Not interested or willing to participate in Suboxone treatment

  3. Best referral site is NOT one of the study's partner clinics in the central MAregion, which will be outpatient MAT clinics and primary care within the UMasssystem and the three other primary facilities outside of the UMass system.

  4. Unwilling to use the OARSCM app (if assigned)

  5. Does not have access to their own smartphone with at least iOS 7.1 or Android 4.2,the minimal technology required to run the app, or not willing to accessclinic-dedicated computer to access the program

  6. Currently in state custody or pending legal action that might lead to imprisonment

  7. Cannot paraphrase the study requirements

  8. Does not read or speak English

  9. Does not reside in the central MA region

  10. Already enrolled into the trial

Study Design

Total Participants: 102
Treatment Group(s): 2
Primary Treatment: MyMAT Software Application
Phase:
Study Start date:
August 22, 2022
Estimated Completion Date:
May 31, 2025

Connect with a study center

  • UMass Chan Medical School

    Worcester, Massachusetts 01655
    United States

    Active - Recruiting

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