Characteristics of mHealth therapy app engagement by young adults with OUD.

While rates of opioid use disorder (OUD) continue to rise across the country, young adults with OUD are at particular risk as they have poorer treatment outcomes and lack developmentally appropriate treatment options. The introduction of mobile applications for OUD present a new avenue to improve treatment outcomes for young adults. One such app, reSET provides app users with weekly cognitive behavioral therapy lessons focusing on addiction with built in contingency management for completion of lessons and negative urine drug screens. This exploratory study aimed to identify the characteristics of patients who engaged with the application, reSET, as well as to describe potential differences in treatment outcomes between engagers and non-engagers. This observational cohort study analyzed clinical and other program data from 35 young adults between the ages of 20-28 that were involved in the care and prescribed medications for OUD in Baltimore, Maryland during the 12-week period of app prescription. Results indicated that young adults had dichotomous levels of engagement, with almost 30% engaging highly with the app, completing >90% of lessons, and approximately 70% having low engagement, completing <25% of lessons. There were no differences in mental health outcomes, but engagers were more likely to be retained in care at the end of the 12-week prescription as compared to non-engagers. Overall, results suggest that mHealth apps targeted for OUD treatment offer potential treatment benefits for young adults, especially regarding treatment retention. Future studies should investigate the treatment and mental health impacts of reSET and other mHealth apps within this population.