Neurocognitive Mechanisms Underlying Smartphone-Assisted Prevention of Relapse in Opioid Use Disorder

智能手机辅助预防阿片类药物使用障碍复发的神经认知机制

基本信息

批准号：
10621945
负责人：
George Andrew James
金额：
$ 51.86万
依托单位：
UNIV OF ARKANSAS FOR MED SCIS
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-01 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10621945
关键词：
2 arm randomized control trial Abstinence Adjuvant Analgesic Alcohol consumption Area Arkansas Attenuated Behavior Body Weight decreased Brain Buprenorphine Cellular Phone Cessation of life Clinical Trials Cognition Coupled Cues Data Dependence Drug Monitoring Drug usage Ecological momentary assessment Energy Intake Enrollment Feedback Functional Magnetic Resonance Imaging Geography Goals Health Healthcare Homelessness Hot Spot Hotlines Individual Individual Differences Inpatients Intervention Location Maps Mental Depression Methadone Modeling Monitor Naltrexone Neurocognitive Notification Opioid Opioid Rotation Outcome Outpatients Overdose Participant Patients Pattern Pharmaceutical Preparations Public Health Randomized Randomized, Controlled Trials Relapse Reporting Resources Risk Role Rural Self Assessment Services Shapes Substance Use Disorder Technology Telemedicine Testing Time Treatment outcome United States Unsafe Sex Urinalysis Withdrawal Symptom Work alcohol misuse arm attentional bias brain behavior brief motivational intervention cigarette smoking craving drug craving efficacious treatment efficacy evaluation geographic barrier health care availability high risk illicit opioid improved innovation insight medication-assisted treatment meetings mobile application mobile computing mortality neural neural network neuroimaging novel opioid epidemic opioid misuse opioid overdose opioid use opioid use disorder personalized intervention prescription opioid recruit reduced alcohol use reduced substance use relapse patients relapse prevention relapse risk response rural area smartphone application smoking cessation tool treatment response urban area young adult

项目摘要

ABSTRACT The rising public health burden of opioid misuse, coupled with high relapse rates among individuals seeking treatment for opioid use disorder, necessitates novel interventions for improving opioid-related treatment response. Mobile technology such as smartphone-based applications (“apps”) represent one such intervention. Although smartphone apps are effective in reducing cigarette and alcohol use, their efficacy for reducing opioid use has not yet been established. The proposed clinical trial would evaluate the app OPTiMA (“OPiate Treatment Mobile App”) to prevent relapse among patients receiving medication-assisted treatment for opioid use disorder. OPTiMA implements two features shown to be effective for reducing substance use: daily self- monitoring of opiate use coupled with personalized feedback. Aim 1 would accrue 204 participants with 1:1 randomization into two arms (OPTiMA vs. Monitoring only) to evaluate differences in monthly opioid use at six months post-enrollment. Aim 2 would enroll a subset of participants (N=120) into a longitudinal functional neuroimaging (fMRI) study to model the neurocognitive mechanisms underlying individual differences in treatment response. Two putative mechanisms (attentional bias for drug cues and cue-induced craving) promoting abstinence would be studied. Aim 3 would explore the use of location-based geographic ecological momentary assessment (GEMA) for targeted intervention when participants enter self-identified areas of high risk for relapse. Collectively, the proposed aims would (1) evaluate mobile technology applications for reducing opiate use, (2) understand the neurocognitive mechanisms of action to improve upon this and other apps aiming to reduce drug use, and (3) evaluate the role of personalized, contextually-relevant intervention to promote successful treatment outcomes.

抽象的阿片类药物滥用造成的公共卫生负担日益加重，加上寻求阿片类药物治疗的个人复发率很高阿片类药物使用障碍的治疗，需要新的干预措施来改善阿片类药物相关的治疗基于智能手机的应用程序（“应用程序”）等移动技术就是这样的干预措施之一。尽管智能手机应用程序可以有效减少香烟和酒精的使用，但它们在减少阿片类药物方面的功效拟议的临床试验将评估应用程序 OPTiMA（“OPiate”）的用途。治疗移动应用程序”），以防止接受阿片类药物辅助治疗的患者复发 OPTiMA 实施了两个被证明可有效减少药物使用的功能：每日自我戒断。监测阿片类药物使用情况以及个性化反馈将吸引 204 名参与者，比例为 1:1。随机分为两组（OPTiMA 与仅监测组），以评估 6 岁时每月阿片类药物使用的差异目标 2 会将一部分参与者 (N=120) 纳入纵向功能研究中。神经影像（fMRI）研究模拟个体差异背后的神经认知机制治疗反应。两种假定的机制（对药物线索的注意偏差和线索引起的渴望）将研究促进禁欲的目标 3 将探索利用基于位置的地理生态。当参与者进入自我识别的高风险区域时进行瞬时评估（GEMA）进行有针对性的干预总的来说，拟议的目标是（1）评估移动技术应用以减少复发风险。阿片类药物的使用，(2) 了解神经认知作用机制，以改进此应用程序和其他应用程序旨在减少药物使用，(3) 评估个性化的、与情境相关的干预措施的作用促进成功的治疗结果。