Rosen Allison D, Shoptaw Steven J, Li Li, Tulu Bengisu, Nieto Omar, Jenkins Steven, Kalmin Mariah M
Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, Suite 1800, 10880 Wilshire Blvd, Los Angeles, CA, 90024, United States, 1 3107946096.
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States.
JMIR Form Res. 2025 Aug 18;9:e63526. doi: 10.2196/63526.
Medication-assisted treatment (MAT) is an effective strategy for treating opioid use disorder and reducing opioid-related overdose deaths, yet retention in treatment remains low. Mobile health (mHealth) platforms may be a useful tool for increasing long-term engagement in MAT programs, but evaluation studies of such platforms are limited.
This study aimed to determine whether the use of the Opioid Addiction Recovery Support (OARS) software platform increased MAT engagement for patients with opioid use disorder.
The Technology Improving Success of Medication-Assisted Treatment in Primary Care Study was a quasi-experimental study conducted at a primary care clinic in the United States between January 2021 and February 2022. OARS is a software platform and mobile app (Q2i, LLC) that includes a dashboard of real-time appointment attendance, urine toxicology (UTOX) results, and educational content as well as messaging and journaling features. All patients who were invited to use OARS and had available data across the study were included in the analysis. The primary outcomes were engagement in treatment, defined as no more than a 35-day gap in appointment attendance, and UTOX. Changes in treatment engagement between the treatment as usual (TAU) period and OARS intervention period were assessed using the effect size (Cohen g) and McNemar chi-square test of discordant pairs.
Among 205 patients invited to use OARS, 123 had available data and were thus included in the analysis. The median age was 37 (IQR 31-42.5 ) years, 61% (75/123) identified as men, and 95.1% (117/123) identified as non-Hispanic White. There were no statistically significant differences in demographic characteristics for patients who used OARS on more than 1 day compared to patients who used OARS on 0 or 1 day, or patients who did versus did not have available data. Among all patients, 20% (25/123) were engaged in appointment attendance during TAU only compared to 27% (33/123) during OARS only (g=0.07; P=.36), and 13% (16/123) were engaged in UTOX during TAU only and 33% (41/123) during OARS only (g=0.21; P≤.01). Among a subsample of 52 patients who used OARS on more than 1 day, 17% (9/52) were engaged in appointment attendance during TAU only compared to 23% (12/52) during OARS only (g=0.07, P=.67), and 13% (7/52) were engaged in UTOX during TAU only and 35% (18/52) during OARS only (g=0.22, P=.05).
Introduction of OARS in a primary care setting may be associated with a moderate change in MAT engagement as measured by UTOX, but not appointment attendance. While barriers to implementation and adoption, including difficulty fully integrating OARS with the clinic's electronic health record, may have attenuated the potential effect of the intervention, this study provides evidence that mHealth interventions, such as OARS, are a promising addition to the MAT treatment landscape.
药物辅助治疗（MAT）是治疗阿片类药物使用障碍和减少阿片类药物相关过量死亡的有效策略，但治疗的留存率仍然很低。移动健康（mHealth）平台可能是提高MAT项目长期参与度的有用工具，但对此类平台的评估研究有限。
本研究旨在确定使用阿片类药物成瘾康复支持（OARS）软件平台是否能提高阿片类药物使用障碍患者的MAT参与度。
“技术改善初级保健中药物辅助治疗的成功率研究”是一项于2021年1月至2022年2月在美国一家初级保健诊所进行的准实验研究。OARS是一个软件平台和移动应用程序（Q2i有限责任公司），包括实时预约出勤、尿液毒理学（UTOX）结果和教育内容的仪表板，以及消息传递和日志记录功能。所有被邀请使用OARS并在整个研究过程中有可用数据的患者都纳入了分析。主要结局是治疗参与度，定义为预约出勤间隔不超过35天，以及UTOX。使用效应量（Cohen g）和不一致对的McNemar卡方检验评估常规治疗（TAU）期和OARS干预期之间治疗参与度的变化。
在205名被邀请使用OARS的患者中，123名有可用数据，因此纳入分析。中位年龄为37（四分位间距31 - 42.5）岁，61%（75/123）为男性，95.1%（117/123）为非西班牙裔白人。与使用OARS 0天或1天的患者相比，或与有可用数据和无可用数据的患者相比，使用OARS超过1天的患者在人口统计学特征上没有统计学显著差异。在所有患者中，仅在TAU期间有20%（25/123）的患者参与预约出勤，而仅在OARS期间为27%（33/123）（g = 0.07；P = 0.36），仅在TAU期间有13%（16/123）的患者参与UTOX，而仅在OARS期间为33%（41/123）（g = 0.21；P≤0.01）。在52名使用OARS超过1天的患者子样本中，仅在TAU期间有17%（9/52）的患者参与预约出勤，而仅在OARS期间为23%（12/52）（g = 0.07，P = 0.67），仅在TAU期间有13%（7/52）的患者参与UTOX，而仅在OARS期间为35%（18/52）（g = 0.22，P = 0.05）。
在初级保健环境中引入OARS可能与UTOX衡量的MAT参与度的适度变化相关，但与预约出勤无关。虽然实施和采用的障碍，包括难以将OARS与诊所的电子健康记录完全整合，可能削弱了干预的潜在效果，但本研究提供了证据表明，诸如OARS之类的移动健康干预措施是MAT治疗领域有前景的补充。
