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一种结合行为和药物治疗阿片类物质使用障碍的新型数字疗法的可行性和可接受性。

Feasibility and acceptability of a novel digital therapeutic combining behavioral and pharmacological treatment for opioid use disorder.

作者信息

Monico Laura B, Eastlick Megan, Michero Darcy, Pielsticker Peyton, Glasner Suzette

机构信息

Department of Clinical Affairs, Pelago, New York, NY, USA.

出版信息

Digit Health. 2024 May 29;10:20552076241258400. doi: 10.1177/20552076241258400. eCollection 2024 Jan-Dec.

Abstract

OBJECTIVE

Despite the worsening of the opioid epidemic, access to quality treatment for opioid use disorder (OUD) including buprenorphine remains a challenge. With the onset of the COVID-19 public health emergency, temporary regulatory changes and expanded reimbursement for telehealth services allowed for the rapid expansion of remote treatment for OUD and increased access to buprenorphine, but limited research exists to support this revolutionary shift in care delivery. This study evaluates the feasibility and acceptability of a novel digital therapeutic intervention for OUD combining buprenorphine and behavioral therapy.

METHODS

Adults ( = 27) with OUD received treatment with daily sublingual buprenorphine and psychosocial treatment delivered digitally via a smartphone app over 12 weeks. Participants were evaluated monthly for continued opioid use, medication adherence, anxiety and depression indicators, abstinence self-efficacy, craving, and overall well-being, as well as a one-time measure of treatment acceptability.

RESULTS

Participants reported increased opioid abstinence days from baseline (= 8.2, SD = 8.6) to 12 weeks per 30 days (= 24.9, SD = 10.1), (20) = -6.5, < .000, with strong medication adherence across study waves (96.2%). Anxiety and depression indicators, and opioid craving significantly decreased, and abstinence self-efficacy and overall well-being significantly increased following the intervention. Participants also demonstrated high rates of treatment engagement.

CONCLUSIONS

As current public health emergency regulatory changes are reviewed for permanency, this feasibility and acceptability study of a novel digital therapeutic intervention for OUD including buprenorphine adds to the growing evidence that supports maintaining telehealth access for quality OUD treatment.

摘要

目的

尽管阿片类药物成瘾问题日益严重,但获得包括丁丙诺啡在内的阿片类药物使用障碍(OUD)的优质治疗仍然是一项挑战。随着新冠疫情公共卫生紧急事件的爆发,临时监管变化以及远程医疗服务报销范围的扩大,使得OUD远程治疗得以迅速扩展,丁丙诺啡的可及性增加,但支持这种护理方式变革性转变的研究有限。本研究评估了一种将丁丙诺啡与行为疗法相结合的新型数字疗法干预措施对OUD的可行性和可接受性。

方法

27名患有OUD的成年人接受了为期12周的每日舌下含服丁丙诺啡治疗,并通过智能手机应用程序以数字方式提供心理社会治疗。每月对参与者进行评估,以了解其阿片类药物的持续使用情况、药物依从性、焦虑和抑郁指标、戒断自我效能感、渴望程度以及整体幸福感,同时进行一次性治疗可接受性测量。

结果

参与者报告称,每30天的阿片类药物戒断天数从基线时的(平均值=8.2,标准差=8.6)增加到12周时的(平均值=24.9,标准差=10.1),(t(20)=-6.5,P<.000),在整个研究期间药物依从性良好(96.2%)。干预后,焦虑和抑郁指标以及阿片类药物渴望程度显著降低,戒断自我效能感和整体幸福感显著提高。参与者的治疗参与率也很高。

结论

在审查当前公共卫生紧急事件监管变化的永久性时,这项关于包括丁丙诺啡在内的OUD新型数字疗法干预措施的可行性和可接受性研究,进一步证明了支持维持远程医疗服务以提供优质OUD治疗的证据越来越多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d56f/11135073/0c8e4ea576d6/10.1177_20552076241258400-fig1.jpg

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