Smartphone App Reduces Opioid Use & Boosts Retention

According to a new study from The University of Texas Health Science Center at San Antonio (UT Health San Antonio), patients with opioid use disorder can reduce their days of opioid usage and stay in treatment longer when they utilize a smartphone app as supportive therapy in conjunction with medication.

The cohort study of 600 underserved patients discovered that those who used the app, which combines contingency management behavioral therapy and peer recovery support, in addition to medication, reduced their opioid use by 35% compared to those who only received medication. Additionally, app users stayed in therapy for approximately 19% longer than those treated with medicine alone.

 These findings suggest that augmenting medication for opioid use disorder with app-based contingency management may provide clinical benefits for underserved patients. Expanding the availability of app-based contingency management may contribute to decreasing the immense societal, economic and personal burden of opioid use.”

Elise Marino, PhD, director of research operations at UT Health San Antonio’s Be Well Institute on Substance Use and Related Disorders

Marino is the lead author of the study “Smartphone App-Based Contingency Management and Opioid Use Disorder Treatment Outcomes,” which was published on December 2 in JAMA Network Open. The other writers are affiliated with UT Health San Antonio’s Department of Psychiatry and Behavioral Sciences and the Be Well Institute.

A necessity to supplement medication.

Opioid use disorder remains a nationwide crisis, contributing to significant morbidity and mortality. According to the study, the yearly societal cost in the United States reached $968.9 billion in 2018.

Medication for opioid use disorder (MOUD), which includes methadone, buprenorphine, and naltrexone, is acknowledged as the sole evidence-based treatment for the condition. This first-line treatment has been demonstrated to considerably reduce opioid-related morbidity and mortality, while also providing consistent cost savings.

However, some patients continue to struggle with lowering opioid use and adhering to their treatment plan, indicating the need for MOUD augmentation. Many illnesses are improved by combining medication and therapy. Contingency management, or CM, is a therapy that offers financial incentives for meeting treatment goals.

This medication has generally been administered in clinics, with the purpose of obtaining an opioid-negative result from urine drug testing. While the outcomes have been varied, various evaluations and studies have revealed that patients treated with MOUD with CM had improved retention and fewer opioid-positive results on urine drug testing.

A long-standing barrier is that patients must attend many in-person appointments per week for therapy. With the current COVID-19 outbreak, many people were hesitant to schedule in-person CM appointments. Additional access constraints, such as transportation, distance from the clinic, and arranging child care, have pushed for alternative possibilities such as telehealth and the use of new technology.

There is an app.
One such technology is the WEconnect Health CM smartphone app. The app provides evidence-based CM within a recovery-oriented paradigm. In addition to offering substance-related behavioral targets, it allows patients to set personal daily goals, both substance-related and not, such as attending a Narcotics Anonymous meeting, going for a walk, or reading.

The software also contains a platform for tracking patients’ progress and payments, as well as motivation to meet their daily goals. Furthermore, WEconnect provides one-on-one peer support and online meetings led by qualified peers. In contrast to traditional CM, the app allows patients to make decisions about their own treatment goals and explore recovery through peer support services that are available anytime and accessible outside of normal clinic hours.

The new study sought to determine whether complementing MOUD with app-based CM is related with fewer days of opioid use at the conclusion of treatment and greater retention than MOUD alone.

The retrospective cohort study, which refers to research that follows a group of people over time, examined data obtained from opioid treatment facilities across Texas between November 1, 2020, and November 30, 2023. The cohort consisted of 600 uninsured or underinsured persons aged 18 and older who chose to get MOUD only or MOUD with CM via the WEconnect smartphone app.

“These results are promising, and they highlight the potential importance of a patient’s decision to use app-based CM,” the researchers concluded. “Despite the challenges of engaging patients in other app-based interventions, adding recovery-oriented, app-based CM may be one way to enhance clinical care and meet the growing needs of historically underserved patients taking MOUD.”