SOAR: Smartphones for Opioid Addiction Recovery

SOAR：用于阿片类药物成瘾康复的智能手机

• 批准号: 10468772
• 负责人: PAUL W GLIMCHER
• 金额: $ 101.09万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10468772
• 关键词: Algorithms; American; Basic Science; Behavior; Buprenorphine; Caring; Cellular Phone; Clinical; Clinical Trials; Clinical Trials Network; Conduct Clinical Trials; Contracts; Cost Measures; Criminal Justice; Data; Data Analyses; Dose; Dropout; Economics; Effectiveness; Event; Eye; Feasibility Studies; Future; Goals; Health Care Costs; Health Care Sector; Health Personnel; Health Policy; Homelessness; Hospitals; Intervention; Measurement; Measures; Methadone; Methodology; National Institute of Drug Abuse; Nurses; Opiate Addiction; Opioid; Outcome; Output; Patients; Pharmaceutical Preparations; Physicians; Pilot Projects; Policies; Population; Probability; Productivity; Professional counselor; Provider; Psychiatry; Publishing; Quality-Adjusted Life Years; Randomized; Recovery; Relapse; Resources; Salivary; Site; Societies; Surveys; System; Testing; Time; Treatment Effectiveness; arm; base; buprenorphine treatment; cohort; cost; cost effective; cost effectiveness; cost-effectiveness evaluation; drug testing; economic evaluation; illicit opioid; improved; inner city; instrument; methadone treatment; opioid misuse; opioid use; opioid use disorder; prediction algorithm; response; safety net; stakeholder perspectives; tool; treatment as usual; usability; user-friendly; willingness

PROJECT SUMMARY Over 2 million Americans suffer from Opioid Use Disorder (OUD) and another 9 million misuse opioids. Treatments for opioid addiction exist, but effectiveness is compromised when subjects use illicit opiates during treatment. Reuse rates during treatment can be high, and reducing illicit opiate use during treatment has thus recently become a major NIDA policy goal. Elevated reuse rates not only compromise treatment effectiveness, but this behavior predicts, and likely drives, treatment dropout. With the support of a NIDA basic science R01, we developed a set of easy-to-use instruments that predict opioid reuse events with about twice the accuracy of any existing tool. The 5-minute battery we developed indicates the numerical probability that a patient will reuse illicit opiates within the next 7-10 days. In a pilot cohort, we successfully migrated this battery to a commercial smartphone platform, and demonstrated 100% retention and >85% compliance (median compliance > 95%) over a use period of up to 4 months. In a survey of our largely homeless MOUD patients we found that 85% already had smartphones and data contracts appropriate for using this platform as a part of their treatment. In a survey of OUD treatment physicians, we found that our system and the reuse prediction it provides, was both highly desirable and usable as implemented. Finally, we found in a reanalysis of data from CTN-0051 that dynamic dosing of this very kind reduces relapse rates. Our primary goal in this mid-scale clinical trial is to test the hypothesis that clinicians who use the output of our mobile system to adjust buprenorphine and methadone dosing achieve lower opiate reuse rates than physicians who provide care-as-usual. Our secondary goal is to examine the usability and desirability of this solution for clinicians with an eye to usability and large-scale deployment. Our third and final goal is to measure the cost-effectiveness of this solution from multiple perspectives. If we are successful it will be possible to employ an algorithmic and measurement-based approach to OUD treatment with methadone and buprenorphine which reduces reuse rates and relapse rates amongst OUD patients.

项目摘要 超过200万美国人患有阿片类药物使用障碍（OUD）和另外900万滥用阿片类药物。 存在阿片类药物成瘾的治疗 治疗。治疗期间的再利用率可能很高，因此在治疗过程中减少非法鸦片使用率 最近成为NIDA的主要政策目标。升高的再利用率不仅损害了治疗效果，而且 但是这种行为可以预测并可能驱动治疗辍学。在NIDA基础科学R01的支持下， 我们开发了一套易于使用的仪器，可预测阿片类药物再利用事件，其准确性约为两倍 任何现有工具。我们开发的5分钟电池表示患者重复使用的数值概率 非法鸦片在接下来的7-10天内。在飞行员队列中，我们成功地将该电池迁移到了广告 智能手机平台，显示100％保留率和> 85％的合规性（中位数> 95％） 最多4个月的使用时间。在对我们的无家可归莫德患者的调查中，我们发现已经有85％ 拥有适合将此平台作为其治疗的一部分的智能手机和数据合同。在调查中 在Oud治疗医师中，我们发现我们的系统和所提供的重用预测都很高 可取的和可实施的可用。最后，我们在重新分析CTN-0051的数据中发现了动态 剂量这种非常降低复发率。我们在这项中期临床试验中的主要目标是测试 假设使用我们移动系统的输出来调整丁丙诺啡和美沙酮的临床医生 与提供照顾的医生相比，剂量可再利用率低。我们的次要目标是 检查该解决方案对临床医生的可用性和可取性，以关注可用性和大规模 部署。我们的第三个也是最终目标是衡量该解决方案的成本效益 观点。如果我们成功，可以采用基于算法和测量的方法 用美沙酮和丁丙诺啡治疗，从而降低了重复使用率和复发率 Oud患者。