Patient- and Provider-Reported Experiences of a Mobile Novel Digital Therapeutic in People With Opioid Use Disorder (reSET-O): Feasibility and Acceptability Study.
Patient- and Provider-Reported Experiences of a Mobile Novel Digital Therapeutic in People With Opioid Use Disorder (reSET-O): Feasibility and Acceptability Study.
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DOI：
10.2196/33073
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发表时间：
2022-03-25
影响因子：
2.2
通讯作者：
Nunes E
中科院分区：
文献类型：
--
作者：
Kawasaki S;Mills-Huffnagle S;Aydinoglo N;Maxin H;Nunes E
治疗阿片使用障碍的药物，如丁丙诺啡，对于解决阿片类药物的流行是有效的和必不可少的。然而，药物的高辍学率仍然是一个挑战。采用应急管理和认知行为咨询的行为治疗显示出改善丁丙诺啡治疗结果的希望，但实施起来很复杂。通过以技术为基础的平台提供行为治疗有可能使其更具广泛传播的可行性。Reset-O是一种处方数字治疗方法，是治疗教育系统的商业改编，是一种基于互联网的计划，采用社区强化方法进行认知行为治疗。它提供认知行为治疗模块和应急管理奖励完成模块和阴性尿液药物筛查。这项试点研究旨在评估Reset-O在以社区为基础的阿片类药物治疗计划中的可行性和可接受性，该计划采用中心和辐条护理模式，作为维持个人治疗的更大战略的一部分。对15个个体进行了RESET-O的客观和定性研究，以及可接受性和亲和性研究。年龄18岁、被诊断为当前阿片类药物使用障碍的讲英语的人在接受丁丙诺啡至少1周的治疗后被招募。在这项为期24周的研究中，为RESET-O开了两张为期12周的处方。在研究的第4、8、12和24周，患者报告RESET-O的药物使用情况和喜好程度。还进行了定性访谈。总共招募了4名提供者，并就RESET-O的可接受性和可行性提供反馈。在参与这项先导性研究的15名参与者中，7名(47%)完成了24周，8名(53%)因登记后辍学、治疗中的磨损或监禁而无法完成。在试点研究期间，参与者完成单元平均获得了96美元的应急管理奖励。参与者的主观反馈显示，Reset-O易于使用，令人愉快，并有助于提供一个安全的空间来承认反复使用药物。在这项初步研究中，根据患者和提供者的反馈，RESET-O被很好地接受；然而，治疗中的依从性和保留率仍然需要改进。需要随机对照试验来评估基于社区的丁丙诺啡治疗的保留是否通过使用基于技术的行为干预措施(如RESET-O)来增强。
Medications for the treatment of opioid use disorder, such as buprenorphine, are effective and essential for addressing the opioid epidemic. However, high dropout rates from medication remain a challenge. Behavioral treatment with contingency management and cognitive behavioral counseling has shown promise for improving the outcomes of buprenorphine treatment but is complicated to deliver. The delivery of behavioral treatment through technology-based platforms has the potential to make it more feasible for widespread dissemination. reSET-O is a prescription digital therapeutic and a commercial adaptation of the Therapeutic Education System, an internet-based program with a Community Reinforcement Approach to cognitive behavioral therapy. It delivers cognitive behavioral therapy modules and contingency management rewards upon completion of modules and negative urine drug screens. This pilot study aims to assess the feasibility and acceptability of reSET-O in a community-based opioid treatment program with a Hub and Spoke model of care as part of a larger strategy to maintain individuals in treatment. Objective and qualitative results, as well as acceptability and likeability of reSET-O, were obtained from 15 individuals. English-speaking individuals aged ≥18 years with a diagnosis of current opioid use disorder were recruited after being on buprenorphine for at least 1 week of treatment. Two 12-week prescriptions for reSET-O were written for the 24-week study. Patient reports of drug use and likeability scales of reSET-O were conducted at weeks 4, 8, 12, and 24 of the study. Qualitative interviews were also conducted. A total of 4 providers were recruited and provided feedback on the acceptability and feasibility of reSET-O. Of the 15 participants who participated in this pilot study, 7 (47%) completed 24 weeks, and 8 (53%) were unable to complete because of dropout after enrollment, attrition in treatment, or incarceration. An average of US $96 in contingency management rewards were earned by participants for the completion of modules for the duration of the pilot study. Participants’ subjective feedback revealed that reSET-O was easy to use, enjoyable, and helped provide a safe space to admit recurring substance use. reSET-O was well accepted based on patient and provider feedback in this pilot study; however, adherence and retention in treatment remain areas for improvement. Randomized control trials are needed to assess whether retention of community-based buprenorphine treatment is enhanced through the use of technology-based behavioral interventions such as reSET-O.
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影响因子：
25.8
作者：
Gustafson, David H.;McTavish, Fiona M.;Chih, Ming-Yuan;Atwood, Amy K.;Johnson, Roberta A.;Boyle, Michael G.;Levy, Michael S.;Driscoll, Hilary;Chisholm, StevenM.;Dillenburg, Lisa;Isham, Andrew;Shah, Dhavan
通讯作者：
Shah, Dhavan
影响因子：
120.7
作者：
MCLELLAN, AT;ARNDT, IO;OBRIEN, CP
通讯作者：
OBRIEN, CP
影响因子：
--
作者：
Hser, YI;Hoffman, V;Anglin, MD
通讯作者：
Anglin, MD
影响因子：
3.9
作者：
Nunes EV;Ball S;Booth R;Brigham G;Calsyn DA;Carroll K;Feaster DJ;Hien D;Hubbard RL;Ling W;Petry NM;Rotrosen J;Selzer J;Stitzer M;Tross S;Wakim P;Winhusen T;Woody G
通讯作者：
Woody G
影响因子：
7
作者：
Lang AJ;Wilkins K;Roy-Byrne PP;Golinelli D;Chavira D;Sherbourne C;Rose RD;Bystritsky A;Sullivan G;Craske MG;Stein MB
通讯作者：
Stein MB