A new study from the University of Texas Health Science Center at San Antonio indicates that a smartphone app can significantly improve outcomes for individuals with opioid use disorder (OUD) when used in conjunction with medication. The study, published in JAMA Network Open, found that patients who used the WEconnect Health CM app alongside medication for opioid use disorder (MOUD) reported fewer days of opioid use and stayed in treatment longer compared to those who only received MOUD.
The study involved 600 participants and compared the outcomes of those who chose to use the app with those who received standard MOUD treatment. The app combines contingency management (CM), a behavioral therapy that provides financial incentives for achieving treatment goals, with recovery support from peers. Participants using the app reported a mean of 8.4 days of opioid use at the end of treatment, compared to 12 days for those receiving MOUD alone (β = -6.10; 95% CI, -8.09 to -4.10; P < .001).
Key Findings
- Reduced Opioid Use: Patients using the app reported a 35% reduction in days of opioid use compared to those on MOUD alone.
- Improved Retention: App users remained in treatment for a mean duration of 290.2 days, compared to 236.1 days for those receiving MOUD only (β = 51.91; 95% CI, 33.86 to 69.95; P < .001).
- Cost-Effective Potential: The study highlights the potential for app-based CM to decrease the societal, economic, and personal burden of opioid use.
Elise Marino, director of research operations at UT Health San Antonio's Be Well Institute on Substance Use and Related Disorders, emphasized the clinical benefits for underserved patients. "These findings suggest that augmenting medication for opioid use disorder with app-based contingency management may provide clinical benefits for underserved patients," Marino stated.
The WEconnect Health CM app distinguishes itself by embedding evidence-based CM within a recovery-oriented framework. Unlike traditional CM, which often requires frequent in-person visits for drug screening, the app allows patients to set personally meaningful daily goals, track progress, and receive encouragement. It also offers access to peer support and online meetings, enhancing engagement and satisfaction with the treatment process.
Addressing the Opioid Crisis
Opioid use disorder remains a significant public health crisis, with an estimated annual societal cost of $968.9 billion in the US. While medications like methadone, buprenorphine, and naltrexone are effective in reducing opioid-related morbidity and mortality, many patients require additional support to maintain abstinence and adhere to treatment plans. The app-based CM approach offers a scalable and accessible solution to augment MOUD and improve patient outcomes.
Study Limitations
The researchers noted several limitations, including the non-randomized design and potential selection bias. Patients self-selected into the app-based CM group, which may have introduced confounding factors. Additionally, the majority of participants identified as White, limiting the generalizability of the findings to other racial and ethnic groups. Despite these limitations, the study provides valuable insights into the potential benefits of integrating technology-based interventions into OUD treatment.
Future Directions
The study authors suggest that future research should focus on randomized controlled trials to further evaluate the effectiveness of app-based CM and identify strategies to increase its adoption among patients and clinicians. As Elise Marino noted, the app is available anytime, anywhere. They don't have to go into a clinic to receive the intervention. So it gives them a little bit more control over the intervention."
By expanding the availability of innovative approaches like app-based CM, healthcare providers can enhance clinical care and address the growing needs of individuals struggling with opioid use disorder.
