Development of a text messaging tool to support buprenorphine treatment in primary care

开发短信工具以支持初级保健中的丁丙诺啡治疗

• 批准号: 10213679
• 负责人: Babak Tofighi
• 金额: $ 18.09万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10213679
• 关键词: Address; Adherence; Administrator; Adoption; Appointment; Attitude; Behavior; Biometry; Buprenorphine; Car Phone; Caring; Chronic Disease; Client satisfaction; Clinical; Complex; Consensus; Counseling; Development; Devices; Disease Management; Dropout; Effectiveness; Electronic Health Record; Elements; Enrollment; Ensure; Epidemic; Feedback; Fellowship; Focus Groups; Fostering; Future; Goals; Group Meetings; Guidelines; Instruction; Intervention; Interview; Logistics; Medical; Modality; Modeling; Modification; National Institute of Drug Abuse; Opiate Addiction; Opioid; Outcome; Outpatients; Patient Education; Patient Self-Report; Patient-Centered Care; Patients; Pattern; Persons; Pharmaceutical Preparations; Pharmacotherapy; Phase; Physicians; Positioning Attribute; Practice Guidelines; Primary Health Care; Provider; Psychosocial Assessment and Care; Public Health; RNA Interference; Randomized Controlled Trials; Reporting; Research; Research Methodology; Self Administration; Self Management; Surveys; Technology; Testing; Text Messaging; Transportation; Treatment outcome; United States Substance Abuse and Mental Health Services Administration; Visit; Withdrawal Symptom; addiction; antiretroviral therapy; base; buprenorphine treatment; clinical practice; cohort; comorbidity; cost; cost effective; design; efficacy trial; evidence base; feasibility testing; follow-up; health care settings; improved; medical specialties; medication compliance; opioid epidemic; opioid misuse; opioid treatment program; patient oriented; patient-clinician communication; personalized approach; personalized care; phase 1 study; preference; prescription opioid addiction; primary care setting; prototype; psychosocial; randomized trial; response; satisfaction; smartphone Application; smoking cessation; substance abuse treatment; support tools; text messaging intervention; therapy design; tool; treatment trial; usability

Project Summary/Abstract: The rising opioid misuse epidemic has intensified efforts to implement cost-effective strategies to expand access to office-based opioid treatment (OBOT). Office-based buprenorphine treatment with elements of patient education, individualized evidence-based care plans, and expert care availability offers a patient- centered approach to reduce the burden of opioid addiction and related comorbidities. OBOT, however, remains underutilized in traditional healthcare settings, and barriers to expansion includes limited clinical and administrative support, particularly during induction and stabilization. Text messaging (TM) offers a low-cost and personalized approach to enhancing buprenorphine treatment in primary care and may address logistical and clinical challenges previously reported by buprenorphine providers. This project investigates the feasibility and clinical impact of a TM intervention to improve adherence to Substance Abuse and Mental Health Services Administration and consensus guidelines to office-based buprenorphine treatment (e.g., adherence to buprenorphine, patient-provider communication, and self-management). The project will develop and conduct preliminary tests of a TM intervention that will improve adherence to buprenorphine treatment, patient-provider communication, and self-management following induction in two phases: 1) identifying key stakeholders (e.g., patients, physicians, and administrators) who will inform the design and delivery of the TM intervention, and 2) assessing the feasibility and clinical impact of this intervention during the first 3 months following induction to buprenorphine. Qualitative and mixed- methods research will explore key stakeholder preferences to intervention design using the Technology Acceptance Model. The TM intervention prototype will undergo usability testing to fine-tune intervention components among patients entering OBOT for induction to buprenorphine. The feasibility and clinical impact of a refined intervention prototype will then be assessed in a pilot randomized controlled trial and identify modifications to optimize the intervention for a future efficacy trial. TM is the most popular mobile phone feature nationally, among patients in addiction treatment, and in OBOT. This low-cost clinical support tool is uniquely positioned to accelerate DHHS and NIDA goals to expand access to substance abuse treatment in traditional healthcare settings. Findings from this project will lead to the development of a patient-centered platform that will: 1) enhance patient-provider communication and solve patient challenges to chronic disease management in primary care including transportation and limited in-person visit slots; 2) improve adherence to buprenorphine treatment by receiving medication reminders; 3) promote self-management through instructions regarding self-administration of comfort medications to quell mild withdrawal symptoms, linkage with psychosocial support, and 12-step group meetings; and 4) integrate with electronic health records and larger-scale adoption in primary care settings nationally.

项目摘要/摘要： 不断上升的阿片类药物滥用流行病已经加强了实施具有成本效益的策略的努力 扩大对基于办公室的阿片类药物治疗（OBOT）的访问。基于办公室的丁丙诺啡治疗 患者教育，个性化的循证护理计划和专家护理可用性为患者提供 减轻阿片类药物成瘾和相关合并症负担的中心方法。但是， 在传统医疗机构中仍未充分利用，扩张的障碍包括有限的临床和 行政支持，特别是在归纳和稳定期间。短信（TM​​）提供低成本 和个性化方法来增强初级保健中的丁丙诺啡治疗，并可能解决后勤 以及以前由丁丙诺啡提供者报道的临床挑战。该项目调查了 TM干预措施的可行性和临床影响，以提高依从性 滥用药物 卫生服务管理和共识 基于办公室的丁丙诺啡治疗指南（例如 遵守丁丙诺啡，患者提供的沟通和自我管理）。 该项目将开发和进行TM干预的初步测试，以改善 遵守丁丙诺啡治疗，患者提供的沟通和自我管理 有两个阶段的归纳：1）确定关键利益相关者（例如患者，医师和管理员） 将告知TM干预的设计和交付，2）评估可行性和临床影响 在丁丙诺啡诱导后的前三个月中，这项干预措施中的干预措施。定性和混合 方法研究将使用该技术探讨关键利益相关者对干预设计的偏好 接受模型。 TM干预原型将经过可用性测试以微调干预 进入丁丙诺啡诱导的患者中的成分。可行性和临床影响 然后，将在一项飞行员随机对照试验中评估精致的干预原型，并确定 修改以优化未来功效试验的干预措施。 TM是全国最受欢迎的手机功能，在成瘾治疗中的患者中以及 OBOT。这种低成本的临床支持工具的独特位置可以加速DHHS和NIDA目标以扩展 在传统医疗机构中获得药物滥用治疗。该项目的发现将导致 以患者为中心的平台的开发：1）增强患者提供者的沟通和 解决患者对初级保健慢性疾病管理的挑战，包括运输和有限 面对面的参观老虎机； 2）通过接受药物提醒来提高丁丙诺啡治疗的依从性； 3） 通过有关自我管理舒适药物的指示来促进自我管理以平息 轻度戒断症状，​​与社会心理支持的联系以及12步组会议； 4）整合 通过电子健康记录和在全国初级保健环境中采用的大规模采用。

项目成果

Early innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review.

• DOI: 10.1186/s13722-021-00275-1
• 发表时间: 2021-11-13
• 期刊: Addiction science & clinical practice
• 影响因子: 3.7
• 作者: Krawczyk N;Fawole A;Yang J;Tofighi B
• 通讯作者: Tofighi B

A Telemedicine Buprenorphine Clinic to Serve New York City: Initial Evaluation of the NYC Public Hospital System's Initiative to Expand Treatment Access During the COVID-19 Pandemic.

• DOI: 10.1097/adm.0000000000000809
• 发表时间: 2022-01-01
• 期刊: Journal of addiction medicine
• 影响因子: 5.5
• 作者: Tofighi B;McNeely J;Walzer D;Fansiwala K;Demner A;Chaudhury CS;Subudhi I;Schatz D;Reed T;Krawczyk N
• 通讯作者: Krawczyk N

Smoking patterns and preferences for technology assisted smoking cessation interventions among adults with opioid and alcohol use disorders.

吸烟模式和对技术的偏好有助于对患有阿片类药物和酒精使用障碍的成年人进行戒烟干预。

• DOI: 10.1080/14659891.2019.1642407
• 发表时间: 2019
• 期刊: Journal of substance use
• 影响因子: 0.8
• 作者: Tofighi,Babak;Lee,JoshuaD;Sherman,Scott;Schatz,Daniel;El-Shahawy,Omar
• 通讯作者: El-Shahawy,Omar

E-cigarette use and beliefs among adult smokers with substance use disorders.

• DOI: 10.1016/j.abrep.2020.100329
• 发表时间: 2021-06
• 期刊: Addictive behaviors reports
• 作者: El-Shahawy O;Schatz D;Sherman S;Shelley D;Lee JD;Tofighi B
• 通讯作者: Tofighi B

Outcomes of a NYC Public Hospital System Low-Threshold Tele-Buprenorphine Bridge Clinic at 1 Year.

• DOI: 10.1080/10826084.2022.2069269
• 发表时间: 2022
• 期刊: SUBSTANCE USE & MISUSE
• 影响因子: 2
• 作者: Tofighi, Babak;McNeely, Jennifer;Yang, Jenny;Thomas, Anil;Schatz, Daniel;Reed, Timothy;Krawczyk, Noa
• 通讯作者: Krawczyk, Noa