JMIR Publications

ABSTRACT

Background:

Opioid use disorder (OUD) is a public health crisis with more than 2 million people living with OUD in the United States. Medication assisted treatment (MAT) is an evidence-based approach to treating OUD that relies on a combination of behavioral therapy and medication, but less than half of individuals living with OUD are accessing this treatment. Mobile technology can enhance treatment of chronic diseases in ways that are readily accessible and cost effective through self-monitoring and support.

Objective:

Our aim is to describe the adaptation of a mobile platform for patients in treatment for OUD and preliminary pilot testing results.

Methods:

Our study was conducted with patient and provider participants at the University of Virginia MAT clinic and was approved by the Institutional Review Board. The formative phase of the study included semi-structured interviews to understand OUD patient needs, provider perspectives, and opportunities for a mobile app to support MAT care. A second round of formative interviews used mock-ups of app features to collect feedback on feature function and desirability for app development. Formative participants' input informed development of a functional smartphone app. Patient and provider participants were then recruited to use the completed platform for a 6-month pilot study. We assessed patient app usage by feature at 1-month. Usability interviews including a system usability score and open-ended questions were also completed at 1-month. Open-ended responses were analyzed for prevalent themes.

Results:

Formative interviews resulted in development of a mobile app, entitled HOPE, that included both evidence-based and participant-prompted features. Features included daily prompts for monitoring mood, stress, treatment adherence, and substance use; patient tracking of goals, reminders, and triggering or encouraging experiences; informational resources; an anonymous community board to share support with other patients; and secure messaging for communication between patients and providers. All patient participants engaged with at least one app feature during their first month of pilot study participation and the daily self-monitoring prompts were the most used. Patient and providers reported high levels of system usability (86.9 ± 10.2 and 83.3 ± 12.8, respectively). Qualitative analysis of open-ended usability questions highlighted the value of self-monitoring, access to support through the app, and a perceived improvement in connection to care and communication for both patient and provider participants.

Conclusions:

Use of the HOPE program by pilot participants, high system usability scoring, and positive perceptions from 1-month interviews indicate successful program development. By engaging with end users and eliciting feedback throughout the development process, we were able to create an app and web portal that was highly usable and acceptable to study participants. Further work is needed to understand the impact of this program on clinical outcomes and patient engagement in and connection to care.