Remote observed dosing to improve Suboxone compliance in clinical practice

远程观察给药以提高临床实践中的 Suboxone 依从性

基本信息

批准号：
9754094
负责人：
KYLE Matthew KAMPMAN
金额：
$ 24.15万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-01 至 2021-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9754094
关键词：
Abstinence Accounting Address Adherence Agonist American Attention Behavior Therapy Behavior monitoring Buprenorphine Cellular Phone Cessation of life Chronic Cognitive Communicable Diseases Communities Control Groups Counseling Data Dose Drug Screening Effectiveness Emergency department visit Evaluation Funding Goals HIV Health Health Services Accessibility Hepatitis B Hepatitis C Individual Intervention Logistics Matched Group Measures Medical Medication Management Methadone Methodology Monitor Moods Morbidity - disease rate Opioid Outcome Measure Outpatients Overdose Participant Patient Self-Report Patients Pennsylvania Pharmaceutical Preparations Physicians Physicians&apos Offices Private Practice Process Public Health Randomized Randomized Clinical Trials Records Regulation Relapse Research Risk Risk Behaviors Sampling Screening Result Secure Suboxone Surveys Telephone Testing Treatment outcome Universities Urine Visit Weight Gain Withdrawal addiction attentional control base behavioral pharmacology buprenorphine treatment clinical care clinical practice cost design effective therapy experimental group health disparity illicit drug use improved innovation medication compliance methadone treatment misuse of prescription only drugs opioid agonist therapy opioid mortality opioid use opioid use disorder overdose death overdose risk prescription opioid prescription pain reliever primary care setting primary outcome programs recruit secondary outcome side effect substance abuse treatment treatment program urinary

项目摘要

PROJECT SUMMARY Opioid Use Disorder (OUD) is a major public health problem. Although several effective treatments that mitigate withdrawal and promote abstinence have been developed and are widely used, physicians have expressed hesitation in prescribing them due to misuse and diversion. The most recent of these treatments, buprenorphine (Suboxone®), can be prescribed by physicians in private practice. While Suboxone® has a lower abuse liability and decreased risk of overdose than methadone, compliance is low and diversion is an ongoing problem. The goal of this project is to develop and test the preliminary efficacy of using remote compliance monitoring in buprenorphine (Suboxone®) treatment for OUD. To that end, 40 subjects with OUD will be recruited through the University of Pennsylvania's Treatment Research Center, an outpatient substance abuse treatment facility. All subjects will receive a smartphone (and data plan); buprenorphine (Suboxone®) (16 mg/day, adjusted as needed according to individual requirements); and counseling in the form of weekly Medication Management (MM) for 12 weeks. Participants will be randomized into one of two groups: remote compliance monitoring or an attention match group that mirrors current clinical care. Using an iterative process we propose to develop an innovative, low cost, and scalable platform physicians can easily integrate into their private practice. Findings from the study will be used to support an R01 application to test the use of remote compliance monitoring in a larger prescription opiate-dependent sample in clinical practices. This methodology has broad applications for increased compliance in office-based treatment for addiction and other chronic medical conditions.

项目概要阿片类药物使用障碍（OUD）是一个主要的公共卫生问题，尽管有几种有效的治疗方法。缓解戒断和促进戒断的药物已经开发出来并被广泛使用，医生们已经由于滥用和转移这些治疗方法，他们对开药表示犹豫。丁丙诺啡 (Suboxone®) 可以由私人诊所的医生开处方，而 Suboxone® 有一种药物。与美沙酮相比，滥用倾向较低，服药过量的风险也较低，依从性较低，且转移是一种该项目的目标是开发和测试使用远程的初步效果。为此，对 40 名 OUD 受试者进行了丁丙诺啡 (Suboxone®) 治疗的依从性监测。将通过宾夕法尼亚大学治疗研究中心招募，这是一个门诊物质所有受试者都将收到智能手机（和数据计划）；（16毫克/天，根据个人需求酌情调整）并以每周的形式进行咨询；为期 12 周的药物管理 (MM) 参与者将被随机分为两组：远程组。使用迭代过程进行依从性监控或反映当前临床护理的注意力匹配小组。我们建议开发一个创新、低成本且可扩展的平台，医生可以轻松地将其集成到他们的私人诊所的研究结果将用于支持 R01 应用程序来测试远程的使用。这种方法在临床实践中对更大的处方阿片依赖样本进行依从性监测。具有广泛的应用，可提高成瘾和其他慢性病的办公室治疗的依从性医疗条件。