Smartphone app can help reduce opioid use and keep patients in treatment, UT Health San Antonio study shows

(Press-News.org) SAN ANTONIO, Dec. 30, 2024 – Patients with opioid use disorder can reduce their days of opioid use and stay in treatment longer when using a smartphone app as supportive therapy in combination with medication, a new study by The University of Texas Health Science Center at San Antonio (UT Health San Antonio) shows.

The cohort study of 600 underserved patients found that those who chose to use the app – which combines contingency management behavioral therapy and recovery support from peers – and alongside medication, reduced their days of opioid use by 35% compared with those treated with medication only. Additionally, app users remained in treatment nearly 19% longer than those treated with medication alone. 

“These findings suggest that augmenting medication for opioid use disorder with app-based contingency management may provide clinical benefits for underserved patients,” said Elise Marino, PhD, director of research operations at UT Health San Antonio’s Be Well Institute on Substance Use and Related Disorders. “Expanding the availability of app-based contingency management may contribute to decreasing the immense societal, economic and personal burden of opioid use.”

Marino is lead author of the study, titled, “Smartphone App-Based Contingency Management and Opioid Use Disorder Treatment Outcomes,” published Dec. 2 in JAMA Network Open. The other authors also are with UT Health San Antonio’s Department of Psychiatry and Behavioral Sciences and the Be Well Institute.

A need to augment medication

Opioid use disorder continues to be a national crisis, contributing to substantial morbidity and mortality. Its annual societal cost in the United States hit $968.9 billion in 2018, the study notes.

Medication for opioid use disorder, or MOUD – including methadone, buprenorphine and naltrexone – is recognized as the only evidence-based treatment for the condition. This first-line treatment has been shown to significantly decrease opioid-related morbidity and mortality, and with consistent cost-saving benefits.

However, some patients still experience difficulties reducing opioid use and staying with their treatment, pointing to a need to augment MOUD. Many conditions benefit from dual treatment of medication and therapy. One therapy is contingency management, or CM, which provides financial incentives for accomplishing treatment goals.

This therapy traditionally has been delivered in clinics, with the goal of an opioid-negative finding from urine drug screens. While findings have been mixed, several reviews and studies have found that individuals treated with MOUD plus CM had better retention and fewer opioid-positive results from urine drug screens.

A long-standing limitation, however, is that patients are required to attend multiple in-person appointments per week for the therapy. With the recent COVID-19 pandemic, many were unwilling to make in-person CM visits. Additional access barriers, such as transportation, distance from the clinic and arranging child care, have supported other options like telehealth and leveraging new technologies.

There’s an app

One such technology is the WEconnect Health CM smartphone app. The app delivers evidence-based CM embedded in a recovery-oriented framework. In addition to providing substance-related behavioral targets, it permits patients to set daily goals that are personally meaningful, both substance use-related and otherwise, like attending a Narcotics Anonymous meeting, going for a walk or reading.

The app also includes a platform for tracking patients’ progress and payment, and provides encouragement for completing their daily goals. Additionally, WEconnect offers 1-to-1 peer support and online meetings facilitated by certified peers. In contrast to traditional CM, the app permits patients to make decisions regarding their own goals for treatment and to explore recovery through peer support services available anywhere and accessible outside of normal clinic hours.

For the new research, the scientists set out to evaluate whether augmenting MOUD with app-based CM is associated with fewer days of opioid use at the end of treatment and greater retention than treatment with MOUD only.

The retrospective cohort study, which refers to research that follows a group of people over time, used data from Nov.1, 2020, to Nov. 30, 2023, collected from opioid treatment programs across Texas. The cohort included 600 individuals aged 18 years or older who were uninsured or underinsured and who chose to receive MOUD only or MOUD plus CM delivered by the WEconnect smartphone app.

Those who chose to receive MOUD plus app-based CM reported a mean duration of 8.4 days of opioid use at the end of treatment compared with 12 days for those who chose to receive MOUD only. Retention analysis showed that patients who chose to receive MOUD plus app-based CM stayed with their treatment for a mean duration of 290.2 days, compared with 236.1 days for those choosing to receive MOUD only.

“These results are promising, and they highlight the potential importance of a patient’s decision to use app-based CM,” the researchers concluded. “Despite the challenges of engaging patients in other app-based interventions, adding recovery-oriented, app-based CM may be one way to enhance clinical care and meet the growing needs of historically underserved patients taking MOUD.”

UT Health San Antonio is a world-class research university, ranking at the top 5% among institutions globally for clinical medicine according to U.S. News & World Report. It is No. 12 in the world among universities for the impact of its discoveries – in normalized citation impact, which compares the number of citations its research receives per paper to the average for similar published work, a recognized core measure of research impact.
 


Smartphone App-Based Contingency Management and Opioid Use Disorder Treatment Outcomes

Elise N. Marino, Tara Karns-Wright, Matthew C. Perez, Jennifer S. Potter

First published: Dec. 2, 2024, JAMA Network Open

Link to full study: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2827185
 

The University of Texas Health Science Center at San Antonio (UT Health San Antonio), a primary driver of San Antonio’s $44.1 billion health care and biosciences sector, is the largest academic research institution in South Texas with an annual research portfolio of $413 million. Driving substantial economic impact with its six professional schools, a diverse workforce of more than 8,500, an annual expense budget of $1.46 billion and clinical practices that provide 2.6 million patient visits each year, UT Health San Antonio plans to add more than 1,500 higher-wage jobs over the next five years to serve San Antonio, Bexar County and South Texas. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.

Stay connected with The University of Texas Health Science Center at San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.

The Be Well Institute on Substance Use and Related Disorders at UT Health San Antonio is a comprehensive, low-barrier system of care that provides compassionate, evidence-based treatment for substance use and related mental health concerns across Texas. Through its hybrid clinic offering virtual and in-person services, a statewide provider network of more than 140 community partners and wraparound services like peer recovery support, the institute reduces barriers to treatment and supports recovery. It also leads cutting-edge research to advance treatment and conducts workforce training to disseminate best practices. Funded by federal and state sources, the institute is dedicated to expanding access, reducing stigma and improving care for individuals and families affected by substance use disorders. Go to bewelltexas.org.

 

END