MHealth Incentivized Adherence Plus Patient Navigation (MIAPP)
Opioid Use Disorder, Medication Adherence, Polysubstance Drug Use (Indiscriminate Drug Use)
About this trial
This is an interventional treatment trial for Opioid Use Disorder
Eligibility Criteria
Inclusion Criteria: Adult greater than or equal to 18 years of age Admitted to Harborview Medical Center (HMC) on any inpatient service Initiated on buprenorphine for OUD while in the hospital or at the time of discharge and planning to continue outpatient Used methamphetamine within the past 30 days (any route of administration or frequency) Willing to be randomized to video-DOT Willing and able to use a smartphone (study can provide) and work with patient navigator Discharge setting does not preclude the use of video-DOT (i.e., nursing home, inpatient psychiatry, etc.) Exclusion Criteria: Unable or unwilling to use smartphone (phones to be provided when needed) Cognitive impairment (acute or chronic) resulting in inability to provide informed consent Currently incarcerated and will discharge to jail or prison Plans to discontinue buprenorphine in the near future (<3 months) Lives far away such that cannot keep study visit at 30 days post-discharge Not English speaking Behavioral risk per discretion of research staff
Sites / Locations
Arms of the Study
Arm 1
Arm 2
No Intervention
Experimental
Treatment-as-usual (TAU)
PN+mHealth
TAU will be usual care that the Addiction Consult Service provides. It is comprised of a multidisciplinary team of professionals, including addiction medicine and addiction psychiatry physicians, nurses specializing in the treatment of OUD, substance use disorder counselors, peer recovery supports, and program coordinators.
The intervention is patient navigation and mHealth in addition to treatment-as-usual. The intervention consists of a patient navigator (PN) with the mHealth adherence application facilitating telehealth visits, two-way chats, video-DOT, and delivery of financial incentives via smartphone for adherence and linkage to outpatient treatment within 30 days. Participants will be asked to upload medication adherence videos once a day over the 30 days post discharge from the hospital. Patients will be instructed to continue to take their medication as prescribed in any circumstance where they are unable to upload the video for any reason.