A Mobile Technology to Extend the Reach of Primary Care for Opioid Misuse

NIDA, R41DA050232

9/30/19 – 8/31/20

Micah Goodman, BS (Rissana, LLC); Patricia A. Cavazos-Rehg, PhD (Washington University)

Opioid use disorder (OUD) has reached epidemic levels in the United States, with catastrophic results: more Americans died from opioid overdoses in 2016 and 2017 than in the entirety of the Vietnam War. Primary care providers (PCPs) serve a critical role in combatting this epidemic, because they see patients who misuse opioids but are not yet dependent in addition to those who are already dependent. However, there is a severe workforce shortage of providers trained to treat substance use disorders, and, furthermore, patients go weeks or months between clinic visits when they struggle every day to recover from misuse or dependence. As a result, there is an urgent need to equip both PCPs and patients with tools to monitor and aid the progress of patients working towards recovery. In this project, we will develop a mobile application, with a working title of uMAT-R Now, that monitors patients, provides tailored educational material, guides them through completing treatment adherence goals using evidence-based behavioral therapy principals, links them to follow-up treatment, includes a directory of local resources, and allows patients to message their PCP and other trusted adults to facilitate shared-decision making. For the PCP, we will build a dashboard through which they can communicate with their patients and monitor their patients’ responses to daily ecological momentary assessments. This Phase I STTR study has two Specific Aims. Specific Aim 1 will focus on patients: in Specific Aim 1a we will measure the ease-of-use of and engagement with uMAT-R Now among patients; in Specific Aim 1b we will measure the extent to which treatment plan adherence is improved and opiate misuse behaviors are discontinued among uMAT-R Now participants versus a control group. Specific Aim 2 will focus on PCPs, measuring their satisfaction with uMAT-R Now’s PCP dashboard and the tool as a whole.

The U.S. is experiencing an unprecedented opioid epidemic that urgently needs to be addressed. In this study, we will develop a mobile application to engage patients who misuse opioids with accessible, useful feedback, all while gathering real-time data that makes it easy for providers to provide better care.