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Evaluating Adaptive Dispenser Initiation Protocols for MySafeRx during Post-detox Buprenorphine Treatment – a Pilot Study

Funding Source

Centers for Disease Control and Prevention (CDC), R01CE0033039; RCT Title: Effects of Remote Motivational Enhancement and MySafeRx on Post-Detox Engagement and Retention in Buprenorphine Treatment

Project Period

9/30/2018 – 9/29/2021

Principal Investigator

Zev Schuman-Olivier, MD (CHA); Kathleen Moore, PhD (USF) (Co-PIs)

Other Project Staff

CHA staff: Michael Flores, PhD, Benjamin Cook, PhD, Cassandra Harding, MPH ; USF staff: Khary Rigg, PhD, Holly Hills, PhD, Amanda Sharp, MPH, Melissa Carlson, BS

Project Summary

The objective of this study is to evaluate an innovative strategy among opioid use disorder patients being discharged from detox in Tampa, Florida. This study will evaluate the extent to which remote motivational enhancement sessions via videoconference and the option for flexible daily dosing at home with MySafeRx can improve engagement and retention with Buprenorphine/Naloxone (B/N) treatment after detox. This study seeks to expand the investigators understanding about what works to prevent opioid overdose by evaluating the effects of remote motivational enhancement (RME) sessions provided via videoconferencing at an inpatient detox facility and during early treatment in order to increase treatment engagement with daily outpatient supervised-dosing of B/N. Participants will use an Android smartphone device to access the MySafeRx app and complete their daily motivational interview sessions. In addition, the study seeks to evaluate the effects of using a locked medication dispenser. The role of the dispenser has not been fully evaluated in the past, and evaluation is needed to determine if the dispenser is necessary at the start of a treatment program or only in response to those participants who have issues with adherence or those that are struggling. This pilot study will generate new knowledge about the most effective way to prevent overdose and engage patients in B/N treatment with observed daily dosing.

Public Health Relevance

Opioid overdoses are a significant problem nationwide and novel interventions that can prevent overdose by improving buprenorphine treatment for opioid use disorder are a public health priority. This study will both investigate the effects of starting remote motivational enhancement during inpatient detoxification on rates of engagement in Buprenorphine/ Naloxone (B/N) treatment and evaluate the impact of MySafeRx, a mobile device application which integrates remote motivational coaching with daily observed dosing from secure electronic pill dispensers at home via videoconference, on treatment retention and overdose prevention. Broad dissemination of this new intervention could help communities across the nation expand and advance their capacity to increase B/N treatment engagement and retention, enhance medication adherence, and prevent overdose.