Treating Polysubstance Use in Methadone Maintenance: Application of Novel Digital Technology
治疗美沙酮维持中的多物质使用:新型数字技术的应用
基本信息
- 批准号:10588517
- 负责人:
- 金额:$ 225.46万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-09-30 至 2025-09-29
- 项目状态:未结题
- 来源:
- 关键词:AbstinenceAddressAdherenceAdoptionAftercareAppointmentAttentionAutomationBehaviorBehavior monitoringBehavioralCellular PhoneClinicClinicalCocaineCocaine use disorderCognitive TherapyCommunitiesCounselingCrimeDataDiseaseDropoutDrug usageEffectivenessElementsEnrollmentEnsureGoalsHIV InfectionsHealthIncentivesInsurance CarriersInterventionLiquid substanceLogisticsMedicare/MedicaidMethadoneMotivationOperant ConditioningOpiate AddictionOpioidOralOutcomeOverdoseParticipantPatientsPatternPersonsPharmaceutical PreparationsPharmacotherapyPlant RootsProcessPublic HealthQuality of lifeRandomizedRandomized Controlled TrialsRecordsRecoveryRecovery SupportResearchResourcesRewardsRiskSalivaStimulantStructureSubstance Use DisorderTechnologyTestingTimeToxicologyTrainingTreatment outcomearmbasebehavioral economicscocaine usecomorbiditycontingency managementdesigndigitaldigital treatmentdisorder later incidence preventiondrug testingeffective interventioneffective therapyevidence baseexperiencefinancial incentivefollow up assessmenthigh riskimprovedinnovationmethadone treatmentmobile applicationnovelopioid treatment programopioid useopioid use disorderoverdose deathpersonalized medicinepolysubstance useportabilityprematureprogramsrandomized trialrelapse riskrelative effectivenessresponsesecondary outcomeservice deliverysmartphone Applicationsubstance usesubstance use treatmentsupport toolstherapy designtime usetooltreatment as usualtreatment centertreatment programtreatment risk
项目摘要
Abstract
Methadone is a highly effective treatment for opioid use disorder (OUD), but many patients
leave treatment prematurely, placing them at high risk of relapse and overdose. Extensive
research shows that comorbid cocaine use is associated with poor retention in methadone
treatment. The proposed study will examine a novel intervention designed to improve
methadone treatment retention and other outcomes among people with opioid and cocaine
polysubstance use. The design is a 2-arm randomized controlled trial conducted over a one-
year period following methadone treatment entry. Retention (primary) and drug use (secondary)
outcomes for methadone treatment as usual (TAU, n=120) will be compared with the addition of
the DynamiCare Health Contingency Management app (TAU+DCM, n=120). DCM is a personal
digital therapy tool provided as an app on the patient’s smart phone. Its central feature is the
delivery of evidence-based contingency management therapy in a convenient, remote, and fully
automated fashion that ensures validity of target behaviors and immediacy of reward delivery.
Two target behaviors relevant to retention will be the primary focus of the DCM program: 1)
abstinence from opiates and cocaine as verified via remote oral fluid testing, and 2) medication
pickup from the methadone program as verified by clinic records. Participants in the TAU+DCM
arm will receive financial rewards for achieving these pre-determined behavioral targets over a
48-week intervention period. Comprehensive assessment of all participants will be conducted at
baseline, 3-, 6- and 12-months. Aim 1: To determine the relative effectiveness of TAU+DCM
compared to TAU alone in improving methadone treatment retention through 12-months post
treatment entry. Aim 2: To determine the relative effectiveness of TAU+DCM compared to TAU
alone in terms of [AIM 2a] reducing opioid use and cocaine use; and [Aim 2b] improving other
secondary outcomes including non-targeted substance use and quality of life through 12-
months post treatment entry. Aim 3: To explore app use patterns, acceptability, and perceived
value of the personalized treatment intervention through 12-months post treatment entry.
Innovation lies in the platform and structure of CM delivery that ensures treatment fidelity with
automation of remote behavioral monitoring and reward delivery without involvement of clinical
staff. This project represents a novel application of digital therapeutics to enhance the
effectiveness of OUD treatment with polysubstance use. Findings from this project can improve
the public health impact of methadone treatment by identifying an effective and scalable
approach to address polysubstance use among patients at heightened risk of treatment dropout.
摘要
美沙酮是一种非常有效的治疗阿片类药物使用障碍(OUD),但许多患者
过早地放弃治疗,使他们面临复发和过量的高风险。广泛
研究表明,共病可卡因的使用与美沙酮的不良保留有关,
治疗这项拟议中的研究将研究一种新的干预措施,旨在改善
阿片类药物和可卡因使用者的美沙酮治疗保留和其他结果
多物质使用。该设计是一项在一项单因素试验中进行的双臂随机对照试验,
进入美沙酮治疗后一年。药物滞留(主要)和药物使用(次要)
将美沙酮治疗的结果与常规治疗(TAU,n=120)进行比较,
DynamiCare健康应急管理应用程序(TAU+DCM,n=120)。DCM是一个个人
数字治疗工具作为患者智能手机上的应用程序提供。其核心特征是
以方便、远程和全面的方式提供基于证据的应急管理治疗,
确保目标行为的有效性和奖励交付的即时性的自动化方式。
与保留相关的两个目标行为将是DCM计划的主要重点:1)
通过远程口腔液体测试验证的阿片类药物和可卡因戒断,以及2)药物治疗
从美沙酮计划中提取,并经诊所记录证实。TAU+DCM的参与者
ARM将获得经济奖励,以实现这些预先确定的行为目标,
48-周干预期。所有参加者的综合评估将在
基线、3个月、6个月和12个月。目的1:确定TAU+DCM的相对有效性
与TAU单独治疗相比,在治疗后12个月内改善美沙酮治疗保留率
治疗入口目的2:确定TAU+DCM与TAU相比的相对有效性
[目的2a]减少阿片类药物和可卡因的使用;[目的2b]改善其他
次要结果包括12- 18岁期间的非靶向物质使用和生活质量,
治疗入组后月数。目的3:探索应用程序的使用模式,可接受性和感知
治疗后12个月内个性化治疗干预的价值。
创新在于CM交付的平台和结构,确保治疗保真度,
远程行为监测和奖励递送的自动化,而不涉及临床
工作人员该项目代表了数字治疗的一种新应用,
使用多种物质治疗OUD有效性。该项目的结果可以改善
美沙酮治疗对公众健康的影响,
这是一种解决退出治疗风险较高的患者使用多种药物问题的方法。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Shannon Gwin Mitchell其他文献
Start-up costs of implementing Screening and Brief Intervention (SBI) for Adolescents (part of Economics of SBI symposium)
- DOI:
10.1186/1940-0640-10-s2-o5 - 发表时间:
2015-09-24 - 期刊:
- 影响因子:3.200
- 作者:
Carolina Barbosa;Laura J Dunlap;Brendan Wedehase;Shannon Gwin Mitchell;Robert P Schwartz;Kristi Dusek;Arethusa S Kirk;Marla Oros;Colleen Hosler;Jan Gryczynski;Barry S Brown - 通讯作者:
Barry S Brown
Implementing adolescent SBIRT in an urban federally qualified health center: generalist vs. specialist service delivery models
- DOI:
10.1186/1940-0640-10-s2-o24 - 发表时间:
2015-09-24 - 期刊:
- 影响因子:3.200
- 作者:
Shannon Gwin Mitchell;Arethusa S Kirk;Marla Oros;Jan Gryczynski;Kristi Dusek;Colleen Hosler;Robert P Schwartz;Barry S Brown;Carolina Barbosa;Laura J Dunlap;David W Lounsbury;Kevin E O'Grady - 通讯作者:
Kevin E O'Grady
Methadone patients in patient-centered treatment: One-year arrest data
- DOI:
10.1016/j.drugalcdep.2016.08.282 - 发表时间:
2017-02-01 - 期刊:
- 影响因子:
- 作者:
Sharon M. Kelly;K.E. O’Grady;Jan Gryczynski;Shannon Gwin Mitchell;Jerome H. Jaffe;Robert P. schwartz - 通讯作者:
Robert P. schwartz
W150 - Effects of Target Self-Selection in an App-Based Contingency Management Intervention to Reduce Substance Use
W150 - 基于应用程序的应急管理干预中目标自我选择对减少物质使用的影响
- DOI:
10.1016/j.drugalcdep.2023.110851 - 发表时间:
2024-07-01 - 期刊:
- 影响因子:3.600
- 作者:
Jesse Fletcher;Win Turner;Jody Kamon;Laura Monico;Maxine Stitzer;Shannon Gwin Mitchell - 通讯作者:
Shannon Gwin Mitchell
Roadmap for Global Youth Substance Use Prevention, Screening, and Early Intervention Research
全球青年物质使用预防、筛查和早期干预研究路线图
- DOI:
10.1016/j.jadohealth.2024.09.023 - 发表时间:
2025-01-01 - 期刊:
- 影响因子:4.500
- 作者:
Verena E. Metz;Marcus Bendtsen;Sidharth Arya;Joel Msafiri Francis;Abhishek Ghosh;Dagmar M. Haller;Sion Kim Harris;Agatha Hinman;Andrea H. Kline-Simon;Sharon Levy;Tracy L. McPherson;Shannon Gwin Mitchell;Dorothy Newbury-Birch;Samir Kumar Praharaj;Paul Toner;Elissa R. Weitzman;Stacy A. Sterling - 通讯作者:
Stacy A. Sterling
Shannon Gwin Mitchell的其他文献
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{{ truncateString('Shannon Gwin Mitchell', 18)}}的其他基金
De-Implementing Opioid Use and Implementing Optimal Pain Management Following Dental Extractions
取消阿片类药物的使用并在拔牙后实施最佳疼痛管理
- 批准号:
9438338 - 财政年份:2017
- 资助金额:
$ 225.46万 - 项目类别:
Health Services Research: Extended Release Naltrexone for Opioid-Dependent Youth
卫生服务研究:针对阿片类药物依赖青少年的缓释纳曲酮
- 批准号:
9003039 - 财政年份:2013
- 资助金额:
$ 225.46万 - 项目类别:
Health Services Research: Extended Release Naltrexone for Opioid-Dependent Youth
卫生服务研究:针对阿片类药物依赖青少年的缓释纳曲酮
- 批准号:
8437478 - 财政年份:2013
- 资助金额:
$ 225.46万 - 项目类别:
Health Services Research: Extended Release Naltrexone for Opioid-Dependent Youth
卫生服务研究:针对阿片类药物依赖青少年的缓释纳曲酮
- 批准号:
8790438 - 财政年份:2013
- 资助金额:
$ 225.46万 - 项目类别:
SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers
在城市联邦合格的卫生中心为青少年实施 SBIRT
- 批准号:
8677856 - 财政年份:2012
- 资助金额:
$ 225.46万 - 项目类别:
SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers
在城市联邦合格的卫生中心为青少年实施 SBIRT
- 批准号:
8368524 - 财政年份:2012
- 资助金额:
$ 225.46万 - 项目类别:
SBIRT Implementation for Adolescents in Urban Federally Qualified Health Centers
在城市联邦合格的卫生中心为青少年实施 SBIRT
- 批准号:
8510619 - 财政年份:2012
- 资助金额:
$ 225.46万 - 项目类别:
Intensive Outpatient v. Outpatient Treatment with Buprenorphine among African Ame
非洲裔美国人中的重症门诊与丁丙诺啡门诊治疗
- 批准号:
7830858 - 财政年份:2009
- 资助金额:
$ 225.46万 - 项目类别:
Intensive Outpatient v. Outpatient Treatment with Buprenorphine among African Ame
非洲裔美国人中的重症门诊与丁丙诺啡门诊治疗
- 批准号:
7943892 - 财政年份:2009
- 资助金额:
$ 225.46万 - 项目类别:
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