Evaluating the Usability, Efficacy and Commercial Utility of a Digital Platform to Deliver Comprehensive Treatment for Opioid Use Disorder

评估数字平台的可用性、功效和商业效用，以提供阿片类药物使用障碍的综合治疗

• 批准号: 9912052
• 负责人: Stephanie Papes
• 金额: $ 22.09万
• 依托单位: BOULDER CARE, INC.
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-30 至 2021-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9912052
• 关键词: Advocate; Ambulatory Care; Behavioral; Buprenorphine; Caring; Cessation of life; Communication; Communities; Complex; Continuity of Patient Care; Cost Savings; County; Development; Disease; Economic Models; Education; Emergency Department patient; Employment Status; Ensure; Epidemic; Evidence based treatment; Fee-for-Service Plans; Feedback; Foundations; Goals; Government; Guidelines; Health Services Accessibility; Home environment; Housing; Incentives; Intervention; Life; Long-Term Care; Medical; Mentorship; Monitor; National Institute of Drug Abuse; Nature; Nurses; Outcome; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Phase; Privatization; Provider; Psychiatric Social Work; Quality of Care; Quality of life; Remunerations; Reporting; Research; Resources; Risk; Risk Behaviors; Rural; Saliva; Savings; Schedule; Services; Social Work; Source; Specialist; Supervision; Technology; Testing; Text; Time; Transportation; Travel; Vision; Visit; Waiting Lists; Work; addiction; barrier to care; base; care delivery; commercial application; cost; digital; drug testing; experience; functional outcomes; functional status; improved; individualized medicine; innovation; medication compliance; mobile application; mobile computing; opioid epidemic; opioid use; opioid use disorder; patient engagement; patient oriented; peer coaching; programs; recruit; rural area; satisfaction; service providers; social stigma; success; telehealth; traditional care; treatment planning; usability; virtual

7. PROJECT SUMMARY Opioid use disorder (OUD) is a problem of national concern. Medication-based treatment (MT) reduces opioid use, associated risk behaviors and death. Despite evidence supporting MT with buprenorphine, in more than ½ of US counties (mainly rural), there are no prescribers. Patients travel long distances, join waitlists, or go without MT. Other barriers to care include lack of transportation, competing demands (work, childcare) and stigma. Combined, lack of access and barriers leaves millions without treatment. Our innovative solution (Boulder) is a telehealth-based treatment solution offering long-term support for OUD. Our vision is to deploy care teams (Prescribing Clinician, Nurse Coach, Care Advocate and Certified Peer Coach for each patient) to deliver a comprehensive array of services, supervised by addiction specialists with decades of experience. Technology enables us to effectively scale a program that meets all of NIDA's guidelines for appropriate oversight, and provides low-barrier, patient-centered interventions (e.g. video medication monitoring and private (at home) random observed saliva drug testing. The long-term goal of this proposal is to build a scalable solution able to reach patients who are unable to access evidence-based treatment. Our digital program promises to dramatically improve the patient experience, boosting patient retention, satisfaction, medication adherence, and functional outcomes by providing low barrier, quality care. The patient-facing product is developed. In preliminary testing, patients reported high satisfaction, engagement, and usability, and access to care was increased by 38% in three months. The overall objective is to evaluate the ability of a virtual platform to create the necessary paradigmatic shift in OUD treatment. To achieve this objective, we propose the following aims: Phase I, Aim I: Advance Boulder's mobile platform development and obtain patient feedback; Phase II, Aim II: Determine Boulder's impact on patient engagement, program retention, access to care, and care continuity; and Phase II, Aim III: Determine Boulder's impact on opioid use and patient functional status. Purchasers of our product (e.g. private/commercial/governmental payors, at-risk provider groups, etc.) who provide remuneration on a per-patient, per-month basis, realizing substantial cost savings through our integrated services. Unlike typical fee-for-service care delivery, our economic model aligns incentives around delivering superior patient outcomes. The virtual OUD treatment product's end-users are resource-constrained patients who will access care no cost to them. Technology enables our team of medical, behavioral, and social service providers to bring comprehensive telehealth-based care for the longitudinal management of addictive disease directly to the patient, rather than bringing the patient to the care. The research team includes staff and affiliates of Boulder, the Addiction Research and Education Foundation and community partners. Boulder's current investors provide a wide range of support services to ensure success through a national network of experienced entrepreneurs and leaders that provide mentorship and guidance.

7.项目摘要 阿片类药物使用障碍（OUD）是一个国家关注的问题。药物治疗（MT）减少阿片类药物 使用、相关风险行为和死亡。尽管有证据支持MT与丁丙诺啡联合使用，但在超过一半的病例中， 在美国的县（主要是农村），没有处方者。患者长途跋涉，加入等候名单，或前往 没有MT。其他护理障碍包括缺乏交通工具，相互竞争的需求（工作，儿童保育）， 耻辱缺乏获得治疗的机会和障碍使数百万人得不到治疗。我们的创新解决方案 （Boulder）是一种基于远程医疗的治疗解决方案，为OUD提供长期支持。我们的愿景是部署 护理团队（处方临床医生、护士教练、护理倡导者和每位患者的认证同行教练）， 提供全面的服务，由具有数十年经验的成瘾专家监督。 技术使我们能够有效地扩展一个符合NIDA所有指导方针的项目， 监督，并提供低障碍，以患者为中心的干预措施（例如视频药物监测和 私人（在家里）随机观察唾液药物测试。该提案的长期目标是建立一个 可扩展的解决方案，能够帮助无法获得循证治疗的患者。我们的数字 该计划有望大幅改善患者体验，提高患者保留率、满意度， 通过提供低障碍、高质量的护理，提高药物依从性和功能结局。面向患者 产品开发。在初步测试中，患者报告了高满意度，参与度和可用性， 在三个月内，获得护理的机会增加了38%。总体目标是评估一个人的能力， 虚拟平台，以创造必要的范式转变，在OUD治疗。为了实现这一目标，我们 提出以下目标：第一阶段，目标一：推进博尔德的移动的平台开发， 患者反馈;第二阶段，目标二：确定博尔德对患者参与度，项目保留率， 获得护理和护理连续性;第二阶段，目标三：确定博尔德对阿片类药物使用的影响， 患者功能状态。我们产品的购买者（例如，私人/商业/政府付款人，风险 供应商团体等）他们以每个病人、每个月为基础提供报酬， 通过我们的综合服务节省成本。与典型的按服务收费的医疗服务不同，我们的经济模式 围绕提供上级患者结果的激励措施。虚拟OUD治疗产品的最终用户是 资源有限的患者将获得免费护理。技术使我们的医疗团队， 行为和社会服务提供商，为纵向 成瘾性疾病的管理直接给病人，而不是把病人带到护理。的 研究小组包括博尔德的工作人员和附属机构，成瘾研究和教育基金会， 社区合作伙伴。博尔德目前的投资者提供广泛的支持服务，以确保成功 通过一个由经验丰富的企业家和领导人组成的全国性网络提供指导和指导。