Text-Messaging Telehealth and Contingency Management for Opioid Use Disorder Treatment Engagement
Trial Snapshot
- Phase
- Not Applicable
- Status
- Active, not recruiting
- Sponsor
- University of Pennsylvania
- Enrollment
- 1,808
- Locations
- 1
- Primary Endpoint
- Engagement in any addiction treatment at 30 days of randomization
Study Overview
Brief Summary
There is growing recognition of the need for approaches to initiate treatment wherever patients touch the health care system, including the Emergency Department (ED). Most research has focused on initiation of medications for opioid use disorder (MOUDs) in the ED rather than ensuring continued treatment post-discharge. The investigators propose to adapt evidence-based interventions to support patients' complex needs and facilitate continued treatment, rather than discharging them and having them navigate outpatient treatment systems with limited support. The research team will randomize participants into 1 of 4 arms to receive varying degrees of augmented usual care, including daily check-ins and contingency management. The investigators plan to examine the effects of check-ins and contingency management on engagement with addiction treatment and equity of treatment effects among racial and ethnic subgroups and assess important moderators of treatment effects.
Detailed Description
The investigators are proposing to conduct a randomized controlled trial to determine the effectiveness of various text-based and contingency management interventions on Opioid Use Disorder patients. Our goals are to measure their engagement with recovery treatment. The research team plan to enroll 1,649 participants into one of the following 4 arms.
Patients enrolled into the Way to Health CareConnect text line as part of usual care and meeting eligibility criteria will be enrolled in this randomized control trial and randomized to:
Augmented usual care (standard Way to HealthCareConnect text line) Patients can call or text the on-call substance use navigators (SUN) from 9a-9p, 7 days a week.
Augmented usual care + text-message check-ins (standard Way to Health CareConnect Text line) Patients can call or text the on-call substance use navigators (SUN) from 9a-9p, 7 days a week AND (text-message check-ins) patients will receive automated text-message check-ins up to once per day for 30 days to see if the patient needs help with anything.
Augmented usual care + contingency management (standard Way to Health CareConnect Text line) and, participants will be compensated for going to their follow-up appointments.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Factorial
- Primary Purpose
- Supportive Care
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Participants must be 18 or older
- •Screen positive for OUD
- •Bridge buprenorphine prescription (emergency department (ED) enrollment - Buprenorphine prescription at ED discharge; Bridge clinic enrollment - new buprenorphine prescription associated with on-demand or drop-in encounter
- •English reading ability
- •Have a mobile phone capable of receiving text messages
Exclusion Criteria
- •Not being up to date with requirements above
Arms & Interventions
Augmented usual care + text-message check-ins
AUC: Standard Way to Health Care text line. Patients can call or text the on-call substance use navigators (SUN) from 9a-9p, 7 days a week.
Text check-in: Patients will also receive incentives for engagement with treatment and
Participants across all arms will receive an intake survey, and follow-up surveys at day 15, day 30, month 3, and month 6.
Intervention: Text Message Check-ins (Behavioral)
Augmented Usual care + Contingency Management (CM)
AUC: Standard Way to Health Care text line. Patients can call or text the on-call substance use navigators (SUN) from 9a-9p, 7 days a week.
Participants across all arms will receive an intake survey, and follow-up surveys at day 15, day 30, month 3, and month 6.
CM: Patients will also receive incentives for engagement with treatment.
Intervention: Contingency Management (Behavioral)
Augmented usual care + text-message check-ins + contingency management
AUC: Standard Way to Health Care text line. Patients can call or text the on-call substance use navigators (SUN) from 9a-9p, 7 days a week.
Text check-in: Patients will also receive incentives for engagement with treatment and
Participants across all arms will receive an intake survey, and follow-up surveys at day 15, day 30, month 3, and month 6.
CM: Patients will also receive incentives for engagement with treatment.
Intervention: Text Message Check-ins (Behavioral)
Augmented usual care + text-message check-ins + contingency management
AUC: Standard Way to Health Care text line. Patients can call or text the on-call substance use navigators (SUN) from 9a-9p, 7 days a week.
Text check-in: Patients will also receive incentives for engagement with treatment and
Participants across all arms will receive an intake survey, and follow-up surveys at day 15, day 30, month 3, and month 6.
CM: Patients will also receive incentives for engagement with treatment.
Intervention: Contingency Management (Behavioral)
Augmented Usual Care (AUC)
AUC: Standard Way to Health Care text line. Patients can call or text the on-call substance use navigators (SUN) from 9a-9p, 7 days a week.
Participants across all arms will receive an intake survey, and follow-up surveys at day 15, day 30, month 3, and month 6.
Outcomes
Primary Outcomes
Engagement in any addiction treatment at 30 days of randomization
Time Frame: 31 days
Engagement in any addiction treatment within 30 days of randomization (measured on day 31)
Secondary Outcomes
- ED and Hospital Utilization and mortality(6 months)
- Engagement in addition treatment within 14 days(15 days)
Investigators
M. Kit Delgado, MD
Assistant Professor of Emergency Medicine and Epidemiology
University of Pennsylvania