Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT03842384 |
Other study ID # |
K23DA046482 |
Secondary ID |
K23DA046482 |
Status |
Completed |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
October 1, 2020 |
Est. completion date |
November 15, 2023 |
Study information
Verified date |
March 2023 |
Source |
Rhode Island Hospital |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
In prior studies, the investigative team developed a combined computer- and text
message-delivered personalized-feedback intervention (iENDURE) designed to enhance motivation
and improve tolerance of distress to support the early phase of buprenorphine treatment.
Specific aims of this subsequent study include conducting a preliminary randomized controlled
trial with 80 participants to examine the efficacy of iENDURE relative to Treatment-as-Usual
(TAU).
Description:
Medication for Opioid Use Disorder (MOUD), which includes the use of Methadone,
Buprenorphine, or long-acting Naltrexone, is an evidence-based approach to the treatment of
Opioid Use Disorder. Buprenorphine, a partial opioid agonist, has grown in popularity over
the last decade because of its safety profile and flexible administration. Despite its
advantages, nearly half of participants are unable to achieve stabilization, and many
discontinue treatment or return to illicit opioid use. Given high rates of noncompliance
and/or dropout, there have been recent calls to find innovative interventions to enhance
motivation, adherence, and retention in MOUD. Distress tolerance (DT), the perceived or
actual ability to handle aversive physical or emotional states, is a transdiagnostic
vulnerability factor implicated in the development and maintenance of affective
symptoms/disorders and substance use. Preliminary work suggests that targeting DT during
treatment may improve outcomes, by promoting the ability to persist in goal directed activity
(e.g., abstinence) even when experiencing distress. Accordingly, an intervention that
cultivates motivation for abstinence above the reinforcing effects of opioids and teaches
adaptive distress tolerance strategies may optimize the induction and stabilization phases of
buprenorphine treatment to improve long-term recovery. Personalized-feedback interventions,
such as decisional balance feedback evaluating the advantages/disadvantages of engaging in a
certain behavior, represent a promising method to enhance engagement in buprenorphine
treatment. Digital health interventions have the capability of reaching a variety of patient
populations and are well-suited to offer support, skills training, and reminders during times
of increased distress that occur in 'real-time' outside of structured treatment settings. The
objective of this study is to test the preliminary efficacy of a combined computer- and text
message-delivered intervention for adults initiating buprenorphine treatment for opioid use
disorder.
Following consent procedures, all participants will complete a brief online survey and then
be randomly assigned to receive either (a) iENDURE, a computer- and text message-delivered
intervention, or (b) treatment-as-usual and no additional intervention. All participants,
regardless of treatment group, will complete a second set of questionnaires following
randomization. All participants will also be scheduled for follow-up assessments at 1-, 4-,
8- and 12-weeks. Participants assigned to treatment-as-usual will engage in care as
determined by their treatment team. Participants randomized to the iENDURE group will also
engage in routine clinical care, however, they will additionally complete a brief computer
intervention introducing designed to enhance motivation through a decisional balance exercise
and improve tolerance of distress through skills training. Information obtained in the
computer intervention will be used to personalize the subsequent text message portion of the
intervention. Participants will receive 8 weeks of personalized text messages that will a)
remind of salient motivational factors, and b) provide recommendations for relevant distress
tolerance skills. Finally, participants in the iENDURE treatment condition will be asked to
complete a individual qualitative interview at the conclusion of the intervention to elicit
feedback for further improvement and refinement of the iENDURE program.