Remote observed dosing to improve Suboxone compliance in clinical practice

项目总结 阿片使用障碍(OUD)是一个主要的公共卫生问题。尽管有几种有效的治疗方法 医生们已经开发出缓解戒断和促进禁欲的药物，并广泛使用 表示由于滥用和转移注意力，在开处方时犹豫不决。最新的治疗方法是， 丁丙诺啡(Suboxone®)，可由医生在私人诊所开具处方。而Suboxone®拥有 与美沙酮相比，滥用的可能性更低，过量服药的风险更低，依从性更低，转移注意力是一种 持续存在的问题。该项目的目标是开发和测试使用Remote 丁丙诺啡(Suboxone®)治疗OUD的依从性监测。为此，40名受试者使用了 将通过宾夕法尼亚大学的治疗研究中心招募，一种门诊物质 虐待治疗机构。所有受试者将收到一部智能手机(和数据套餐)；丁丙诺啡(Suboxone®) (每天16毫克，根据个人需要调整)；每周咨询 用药管理(MM)12周。参与者将被随机分成两组：远程 依从性监测或反映当前临床护理的注意匹配组。使用迭代过程 我们建议开发一个创新、低成本和可扩展的平台，医生可以轻松地集成到他们的 私人诊所。研究结果将用于支持R01应用程序，以测试Remote 临床实践中对更大的处方阿片依赖样本的依从性监测。这种方法论 广泛应用于提高对成瘾和其他慢性疾病的办公室治疗的遵从性 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.