January 17, 2019
2 min read

CDC awards grant to study incentives, smartphone app for buprenorphine adherence

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Image of August Holtyn
August Holtyn

Researchers at Johns Hopkins University School of Medicine have received a $2.1 million grant from the CDC to examine whether financial incentives plus a smartphone app will improve medication adherence to buprenorphine therapy for patients with opioid use disorder, according to a press release.

“Of the nearly 2.1 million Americans with an opioid use disorder, only 20% of those individuals are in treatment,” August Holtyn, PhD, assistant professor of psychiatry and behavioral sciences at Johns Hopkins and lead author of the study, told Healio Psychiatry. “Stigma around substance use disorders remains a significant barrier to any advancements in treatment. Using this technology could improve providers' confidence in prescribing medication-assisted treatment such as buprenorphine because it offers a way to stay connected to the patient and support them throughout treatment.”

The free app, known as emocha, delivers video directly observed therapy (DOT) to help patients stay adherent to medication, according to the release. Using the app, study participants will film themselves taking buprenorphine and report any related side effects. Then, researchers will review the videos via a secure web portal, verify each dose and contact patients to encourage adherence to their medication when necessary.

Those who take their medication will receive a financial incentive of a few dollars for every day that they take their buprenorphine dose as prescribed, according to Holtyn. Also, patients can check a progress page that will show their adherence and the amount of money earned over time.

Source: Adobe Stock

Participants will be referred to buprenorphine treatment and randomly assigned to a usual care (control) group or video DOT+ group for 24 weeks, Holtyn said. Johns Hopkins researchers will examine whether this combination of video DOT and financial incentives can improve medication adherence, promote treatment retention and decrease the risk for opioid overdose. In addition, they will examine these measures 12 weeks after the intervention ends to determine post-intervention effects.

“Research over the past 40 years has shown that behavioral economic incentive interventions — also called ‘contingency management’ interventions — are some of the most effective psychosocial treatments for substance use disorders,” Holtyn told Healio Psychiatry.

“Incentive interventions, like the intervention in our study, provide incentives (eg, through vouchers or reloadable credit cards) to substance abuse patients when they meet therapeutic goals,” she continued. “The provision of incentives for buprenorphine adherence verified through video directly-observed therapy could promote high rates of buprenorphine adherence and safeguard against diversion.”

Holtyn explained that the study will be promoted by word of mouth through partners, and participants can enter the study if they have opioid use disorder, are not taking opioid use disorder treatment, want to receive buprenorphine treatment, are not pregnant, do not have suicidal/homicidal thoughts and are willing to use a smartphone. – by Savannah Demko

Disclosure: Johns Hopkins holds a license agreement with emocha — which entitles them to fees and royalty distributions related to technology used in the study — and owns equity in emocha.