Smith Crystal L, Keever Abigail, Bowden Theresa, Olson Katie, Rodin Nicole, McDonell Michael G, Roll John M, Smoody Gillian, LeBrun Jeff, Miguel Andre Qc, McPherson Sterling M
Department of Community and Behavioral Health, Elson S Floyd College of Medicine, Washington State University, Spokane, WA, United States.
Analytics and PsychoPharmacology Laboratory, Washington State University, Spokane, WA, United States.
JMIR Form Res. 2023 Apr 19;7:e40437. doi: 10.2196/40437.
Opioid use disorders impact the health and well-being of millions of Americans. Buprenorphine and naloxone (BUP and NAL) can reduce opioid overdose deaths, decrease misuse, and improve quality of life. Unfortunately, poor medication adherence is a primary barrier to the long-term efficacy of BUP and NAL.
We aimed to examine patient feedback on current and potential features of a Bluetooth-enabled pill bottle cap and associated mobile app for patients prescribed BUP and NAL for an opioid use disorder, and to solicit recommendations for improvement to effectively and appropriately tailor the technology for people in treatment for opioid use disorder.
A convenience sample of patients at an opioid use disorder outpatient clinic were asked about medication adherence, opioid cravings, experience with technology, motivation for treatment, and their existent support system through a brief e-survey. Patients also provided detailed feedback on current features and features being considered for inclusion in a technology designed to increase medication adherence (eg, inclusion of a personal motivational factor, craving and stress tracking, incentives, and web-based coaching). Participants were asked to provide suggestions for improvement and considerations specifically applicable to people in treatment for opioid use disorder with BUP and NAL.
Twenty people with an opioid use disorder who were prescribed BUP and NAL participated (mean age 34, SD 8.67 years; 65% female; 80% White). Participants selected the most useful, second-most useful, and least useful features presented; 42.1% of them indicated that motivational reminders would be most useful, followed by craving and stress tracking (26.3%) and web-based support forums (21.1%). Every participant indicated that they had at least 1 strong motivating factor for staying in treatment, and half (n=10) indicated children as that factor. All participants indicated that they had, at some point in their lives, the most extreme craving a person could have; however, 42.1% indicated that they had no cravings in the last month. Most respondents (73.7%) stated that tracking cravings would be helpful. Most respondents (84.2%) also indicated that they believed reinforcers or prizes would help them achieve their treatment goals. Additionally, 94.7% of respondents approved of adherence tracking to accommodate this feature using smart packaging, and 78.9% of them approved of selfie videos of them taking their medication.
Engaging patients taking treatment for opioid use disorder with BUP and NAL allowed us to identify preferences and considerations that are unique to this treatment area. As the technology developer of the pill cap and associated mobile app is able to take into consideration or integrate these preferences and suggestions, the smart cap and associated mobile app will become tailored to this population and more useful for them, which may encourage patient use of the smart cap and associated mobile app.
阿片类药物使用障碍影响着数百万美国人的健康和幸福。丁丙诺啡和纳洛酮（BUP和NAL）可以减少阿片类药物过量致死率，减少滥用，并改善生活质量。不幸的是，药物依从性差是BUP和NAL长期疗效的主要障碍。
我们旨在调查患者对一种用于开具BUP和NAL治疗阿片类药物使用障碍患者的蓝牙药瓶盖及相关移动应用程序的现有和潜在功能的反馈，并征求改进建议，以便为接受阿片类药物使用障碍治疗的人群有效且适当地定制该技术。
通过简短的电子调查问卷，询问了一家阿片类药物使用障碍门诊诊所的患者便利样本关于药物依从性、阿片类药物渴望、技术使用体验、治疗动机以及他们现有的支持系统。患者还就旨在提高药物依从性的技术的现有功能和考虑纳入的功能提供了详细反馈（例如，纳入个人激励因素、渴望和压力追踪、激励措施以及基于网络的辅导）。参与者被要求提供改进建议以及专门适用于接受BUP和NAL治疗的阿片类药物使用障碍患者的考虑因素。
20名被开具BUP和NAL治疗阿片类药物使用障碍的患者参与了研究（平均年龄34岁，标准差8.67岁；65%为女性；80%为白人）。参与者选择了所展示的最有用、第二有用和最没用的功能；42.1%的参与者表示激励提醒将最有用，其次是渴望和压力追踪（26.3%）以及基于网络的支持论坛（21.1%）。每位参与者都表示他们至少有1个坚持治疗的强烈激励因素，一半（n = 10）表示是孩子。所有参与者都表示他们在生活中的某个时候有过一个人可能有的最极端的渴望；然而，42.1%的参与者表示他们在过去一个月没有渴望。大多数受访者（73.7%）表示追踪渴望会有帮助。大多数受访者（84.2%）还表示他们认为强化物或奖品会帮助他们实现治疗目标。此外，94.7%的受访者赞成使用智能包装来实现这一功能的依从性追踪，78.9%的受访者赞成拍摄他们服药的自拍视频。
让接受BUP和NAL治疗阿片类药物使用障碍的患者参与进来，使我们能够识别出该治疗领域特有的偏好和考虑因素。随着药瓶盖及相关移动应用程序的技术开发者能够考虑或整合这些偏好和建议，智能药瓶盖及相关移动应用程序将更适合这一人群且对他们更有用，这可能会鼓励患者使用智能药瓶盖及相关移动应用程序。
