Opioid Use Disorder Clinical Trial
Official title:
MySafeRx & MedicaSafe Open-Label Buprenorphine Induction and Lapse Evaluation (MyMOBILE)
The goal of the MyMOBILE study is to evaluate the feasibility, acceptability, and usability of a novel platform that integrates text messaging reminders, secure electronic pill organizers, and daily remote brief motivational recovery support visits with a standardized protocol for supervised self-administration of buprenorphine via videoconferencing.
Opioid use disorder is a serious public health issue. Buprenorphine/ Naloxone (B/N) is a
partial opioid mu-receptor agonist dosed daily that prevents opioid withdrawal, blocks opioid
euphoria and can prevent opioid overdose. Extended treatment with B/N increases rates of
abstinence and outpatient treatment retention and decreases Hepatitis C (HCV) transmission.
B/N treatment dropout is associated with relapse and overdose death.
B/N adherence may be a critical factor influencing retention and reducing overall healthcare
costs. Also, B/N diversion is associated with poor adherence and has become increasingly
common and worrisome. While many patients achieve stability after starting B/N treatment,
more than 80% of 18-25 year olds leave treatment within a year with relapse as the most
common reason. Ongoing illicit opioid use during treatment increases odds of relapse and
dropout. The MySafeRx platform helps prescribers offer a higher level of support for
vulnerable patients with opioid use disorder during periods of clinical instability. The
MySafeRx platform is a combination of several key components, including daily
videoconferencing check-ins with motivational interviewing-based recovery coaching,
text-messaging reminders, secure storage of B/N medication within a secure electronic pill
dispenser, and a standardized protocol for supervising self-administration of medication via
videoconferencing. By offering this recovery support and medication adherence monitoring
program during periods of instability, this system could improve treatment outcomes by
ensuring increased adherence, while also preventing B/N diversion.
This study primarily seeks to demonstrate the feasibility of the MySafeRx platform among
young adults (18-39 years, inclusive) with opioid use disorders. While each key component may
have an individual therapeutic effect, the investigators hypothesize that an integrated
process involving all key components may be necessary to unlock the full therapeutic
potential of a mobile platform for daily remote supervised self-administration and diversion
prevention among this group. Providing targeted motivational interviewing and recovery
support at this context-specific moment of daily medication-taking when people are very
receptive to treatment may offer a new opportunity for expanding how recovery support can be
delivered.
This study will enroll patients (18-39 years old) in office-based opioid treatment currently
prescribed buprenorphine by a CHA prescriber who had illicit-opioid positive urine screens in
the past week or who have just received buprenorphine induction. We will start participants
with MySafeRx using the MedicaSafe 3000 dispenser and will assess for feasibility,
acceptability, and usability during a 30 day period. Assessments will be conducted at
baseline, two and four weeks.
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