TY - JOUR
AU - Zev Schuman-Olivier
AU - Jacob T. Borodovsky
AU - Jackson Steinkamp
AU - Qays Munir
AU - Kyle Butler
AU - Mary Ann Greene
AU - Jonah Goldblatt
AU - Hai Yi Xie
AU - Lisa A. Marsch
A1 - 
AB - BACKGROUND: While buprenorphine/naloxone (B/N) is approved for opioid use disorder treatment, effective delivery of B/N comes with significant challenges. Most notably, many patients do not take medication daily as prescribed; this non-adherence worsens treatment outcomes, increases healthcare costs, and leads to persistent worries of diversion among providers and policymakers. The present study examines the feasibility, usability, and acceptability of MySafeRx-a mobile technology platform integrating motivational coaching, adherence monitoring, and electronic pill dispensing designed to address the challenges of office-based opioid treatment (OBOT) with B/N. METHODS: The MySafeRx platform integrates electronic pill dispensers, text-messaging, and videoconferencing to provide supervised self-administration of medication and daily motivational coaching through an Android app interface. High-risk early adults (18-39 years old) who were enrolled in OBOT with B/N and had documented illicit opioid use in the past month during opioid agonist therapy (n = 12) participated in a 28-day single-arm observational study of the MySafeRx platform in addition to standard care. RESULTS: Two-thirds of participants who completed the study achieved an average of > 5 days per week of supervised B/N self-administration. Visual confirmation of medication adherence was demonstrated for an average of 72% of study days among all participants. All participants achieved platform technical proficiency within 60 min, reporting good levels of usability and acceptability. Illicit opioid abstinence rates confirmed by urine toxicology increased by 53% during MySafeRx but fell 43% within 3 weeks post-intervention. CONCLUSION: The MySafeRx medication adherence and remote coaching mobile platform is acceptable and can be feasibly implemented in real-world opioid use disorder treatment settings during high-risk periods (i.e., initial stabilization, after illicit opioid lapse), resulting in reduced illicit opioid use; however, the effect did not last after intervention completion, suggesting longer duration or extended taper of program may be needed. ClinicalTrials.Gov NCT02942199 10/24/16 https://clinicaltrials.gov/ct2/show/NCT02942199.
AD - Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA. zschuman@cha.harvard.edu.; Department of Psychiatry, Harvard Medical School, Boston, USA. zschuman@cha.harvard.edu.; Cambridge Health Alliance, Outpatient Addiction Services, Department of Psychiatry, Harvard Medical School, 26 Central Street, Somerville, MA, 02143, USA. zschuman@cha.harvard.edu.; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA.; Cambridge Health Alliance, Outpatient Addiction Services, Department of Psychiatry, Harvard Medical School, 26 Central Street, Somerville, MA, 02143, USA.; Boston University School of Medicine, Boston, USA.; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA.; Cambridge Health Alliance, Outpatient Addiction Services, Department of Psychiatry, Harvard Medical School, 26 Central Street, Somerville, MA, 02143, USA.; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA.; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA.; Cambridge Health Alliance, Outpatient Addiction Services, Department of Psychiatry, Harvard Medical School, 26 Central Street, Somerville, MA, 02143, USA.; Tufts University School of Medicine, Boston, USA.; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA.; Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA.
BT - Addiction science & clinical practice
C5 - Opioids & Substance Use
CP - 1
CY - England
DO - 10.1186/s13722-018-0122-4
IS - 1
JF - Addiction science & clinical practice
LA - eng
M1 - Journal Article
N2 - BACKGROUND: While buprenorphine/naloxone (B/N) is approved for opioid use disorder treatment, effective delivery of B/N comes with significant challenges. Most notably, many patients do not take medication daily as prescribed; this non-adherence worsens treatment outcomes, increases healthcare costs, and leads to persistent worries of diversion among providers and policymakers. The present study examines the feasibility, usability, and acceptability of MySafeRx-a mobile technology platform integrating motivational coaching, adherence monitoring, and electronic pill dispensing designed to address the challenges of office-based opioid treatment (OBOT) with B/N. METHODS: The MySafeRx platform integrates electronic pill dispensers, text-messaging, and videoconferencing to provide supervised self-administration of medication and daily motivational coaching through an Android app interface. High-risk early adults (18-39 years old) who were enrolled in OBOT with B/N and had documented illicit opioid use in the past month during opioid agonist therapy (n = 12) participated in a 28-day single-arm observational study of the MySafeRx platform in addition to standard care. RESULTS: Two-thirds of participants who completed the study achieved an average of > 5 days per week of supervised B/N self-administration. Visual confirmation of medication adherence was demonstrated for an average of 72% of study days among all participants. All participants achieved platform technical proficiency within 60 min, reporting good levels of usability and acceptability. Illicit opioid abstinence rates confirmed by urine toxicology increased by 53% during MySafeRx but fell 43% within 3 weeks post-intervention. CONCLUSION: The MySafeRx medication adherence and remote coaching mobile platform is acceptable and can be feasibly implemented in real-world opioid use disorder treatment settings during high-risk periods (i.e., initial stabilization, after illicit opioid lapse), resulting in reduced illicit opioid use; however, the effect did not last after intervention completion, suggesting longer duration or extended taper of program may be needed. ClinicalTrials.Gov NCT02942199 10/24/16 https://clinicaltrials.gov/ct2/show/NCT02942199.
PP - England
PY - 2018
SN - 1940-0640; 1940-0632
SP - 21
T1 - MySafeRx: a mobile technology platform integrating motivational coaching, adherence monitoring, and electronic pill dispensing for enhancing buprenorphine/naloxone adherence during opioid use disorder treatment: a pilot study
T2 - Addiction science & clinical practice
TI - MySafeRx: a mobile technology platform integrating motivational coaching, adherence monitoring, and electronic pill dispensing for enhancing buprenorphine/naloxone adherence during opioid use disorder treatment: a pilot study
U1 - Opioids & Substance Use
U2 - 30249279
U3 - 10.1186/s13722-018-0122-4
VL - 13
VO - 1940-0640; 1940-0632
Y1 - 2018
Y2 - Sep 24
ER -