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Open Trial of Technology-Enhanced Behavioral Intervention for Buprenorphine Retention in Pregnant and Postpartum People

Early Phase 1
Recruiting
Conditions
Pregnancy Related
Opioid Use Disorder
Interventions
Behavioral: Empowering Pregnant Women and People Receiving Medications for Opioid Use Disorder
Registration Number
NCT06496230
Lead Sponsor
Medical University of South Carolina
Brief Summary

This study involves testing how useful a technology-enhanced intervention is for pregnant people prescribed buprenorphine for the management of opioid use disorder. The intervention being studied is a brief therapy protocol and a mobile application. Participation involves four 60-minute therapy appointments during pregnancy, and four 30-minute therapy appointments at the end of pregnancy through 3 months postpartum. The mobile application will be accessible for at least the duration of the study. Participants will also be asked to complete questionnaires at enrollment and again at 1-month postpartum and 3-months postpartum, will send monthly photos of their prescription bottle/box, and will be contacted randomly throughout the study to perform a medication count. The total duration of the study is between 5-9 months depending on when you enroll (early second trimester-mid third trimester). Compensation is provided.

Detailed Description

Medication for opioid use disorder (MOUD) can effectively prevent overdose and death for pregnant and postpartum people with opioid use disorder (OUD). Yet, only half of birthing people continue to use MOUD postpartum, increasing risk for overdose two-fold. This study will evaluate acceptability of a technology-enhanced behavioral intervention that aims to improve retention in and adherence to MOUD during the peripartum period. The intervention contains a brief behavioral intervention targeting malleable risk factors for treatment dropout, opioid cravings, and return to illicit opioid use: anxiety sensitivity and sleep deficiency. An adjunctive mobile application will supplement therapy sessions and contains a medication adherence feature involving daily (or multiple/day) notification reminder to take medication at a scheduled time and dose consistent with the participant's prescription.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
26
Inclusion Criteria
  • Currently pregnant and less than 33 weeks gestational age,
  • History of OUD within past 3 years,
  • Confirmed prescription for sublingual buprenorphine products (i.e., Suboxone, Subutex, Zubsolv) for the purpose of treating OUD,
  • Living in the United States,
  • Between 18-45 years of age.
Exclusion Criteria
  • Carrying multiples (i.e., twins, triplets, etc.);
  • High-risk pregnancies including the following conditions: hyperemesis defined as hospitalization for intractable nausea and vomiting, hypertensive disorders of pregnancy (e.g., gestational hypertension, preeclampsia), placenta previa, or vaginal bleeding in current pregnancy after the first trimester;
  • Current psychotic symptoms and/or active suicidal intent;
  • Experiencing cognitive or emotional impairment that precludes providing informed consent;
  • Incarcerated/pending incarceration or institutionalized during the study period.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Empowering Pregnant Women and People Receiving Medications for Opioid Use DisorderEmpowering Pregnant Women and People Receiving Medications for Opioid Use DisorderEMPWR is a two-pronged intervention model developed for pregnant and postpartum people with opioid use disorder that is comprised of 1) a provider-driven, telemedicine-based behavioral intervention to enhance medication for opioid use disorder (MOUD) retention; and 2) an adjunctive mobile application to promote patients' MOUD adherence and use of therapy skills. The EMPWR therapy protocol is comprised of four 60-minute sessions delivered biweekly by a therapist during the third trimester of pregnancy, and three booster sessions postpartum.
Primary Outcome Measures
NameTimeMethod
Intervention Feasibility1 year

Feasibility of the intervention (e.g., Recruitment: 20 pregnant women with OUD prescribed buprenorphine; Study retention: ≥50% participants retained through 3-month postpartum assessment; Protocol adherence: ≥50% attend all EMPWR therapy sessions;145 Satisfaction: qualitative feedback to assess what participants liked/did not like about the intervention)

Secondary Outcome Measures
NameTimeMethod
Buprenorphine retention6 months

Prescription drug monitoring program (y/n)

Buprenorphine adherence6 months

Mobile application data, medication possession ratios (%)

Trial Locations

Locations (1)

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

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