Remote observed dosing to improve Suboxone compliance in clinical practice

项目摘要 阿片类药物使用障碍（OUD）是一个主要的公共卫生问题。虽然有几种有效的治疗方法， 减轻戒断和促进禁欲已经开发并广泛使用，医生已经 由于滥用和转移，在开处方时表示犹豫。最新的治疗方法， 丁丙诺啡（Suboxone®），可以由私人执业医生开处方。虽然Suboxone®具有 与美沙酮相比，滥用倾向较低，过量的风险降低，依从性低，转移是一种 持续的问题。本项目的目标是开发和测试使用远程 丁丙诺啡（Suboxone®）治疗OUD的依从性监测。为此，40名OUD受试者 将通过宾夕法尼亚大学的治疗研究中心招募， 虐待治疗中心所有受试者将接受智能手机（和数据计划）;丁丙诺啡（Suboxone®） (16 mg/天，根据个人需要进行调整）;以及每周一次的咨询 药物管理（MM）12周。参与者将被随机分为两组：远程 依从性监测或反映当前临床护理的注意力匹配组。使用迭代过程 我们建议开发一个创新的、低成本的、可扩展的平台，医生可以很容易地集成到他们的 私人执业。研究结果将用于支持R 01应用程序，以测试远程 在临床实践中更大的处方阿片类药物依赖样本的依从性监测。这种方法 具有广泛的应用，以提高成瘾和其他慢性疾病的基于办公室的治疗的依从性。 医疗条件。

PROJECT SUMMARY Opioid Use Disorder (OUD) is a major public health problem. Although several effective treatments that mitigate withdrawal and promote abstinence have been developed and are widely used, physicians have expressed hesitation in prescribing them due to misuse and diversion. The most recent of these treatments, buprenorphine (Suboxone®), can be prescribed by physicians in private practice. While Suboxone® has a lower abuse liability and decreased risk of overdose than methadone, compliance is low and diversion is an ongoing problem. The goal of this project is to develop and test the preliminary efficacy of using remote compliance monitoring in buprenorphine (Suboxone®) treatment for OUD. To that end, 40 subjects with OUD will be recruited through the University of Pennsylvania's Treatment Research Center, an outpatient substance abuse treatment facility. All subjects will receive a smartphone (and data plan); buprenorphine (Suboxone®) (16 mg/day, adjusted as needed according to individual requirements); and counseling in the form of weekly Medication Management (MM) for 12 weeks. Participants will be randomized into one of two groups: remote compliance monitoring or an attention match group that mirrors current clinical care. Using an iterative process we propose to develop an innovative, low cost, and scalable platform physicians can easily integrate into their private practice. Findings from the study will be used to support an R01 application to test the use of remote compliance monitoring in a larger prescription opiate-dependent sample in clinical practices. This methodology has broad applications for increased compliance in office-based treatment for addiction and other chronic medical conditions.