Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 24, 2020
Date Accepted: May 4, 2021
Approaches for implementing app-based digital treatments for drug use disorders into primary care: A qualitative, user-centered design study of patient perspectives
ABSTRACT
Background:
Digital interventions, such as websites and smartphone apps, can be effective for treating drug use disorders. However, their implementation in primary care is hindered in part by a lack of knowledge about how patients might like these treatments delivered to them.
Objective:
This study aimed to increase understanding of how patients with drug use disorders prefer to receive app-based treatments to inform the implementation of these treatments in primary care.
Methods:
We combined methods of user-centered design with qualitative research methods to inform the design of workflows for offering app-based treatments in primary care. Adult patients (n=14) with past-year cannabis, stimulant, or opioid use disorder from five Seattle-area primary care clinics of Kaiser Permanente Washington participated. Semi-structured interviews were recorded, transcribed, and analyzed with qualitative template analysis. A coding scheme included deductive codes based on interview topics, which primarily focused on workflow design. Inductive codes emerged from the data.
Results:
Participants wanted to learn about apps during visits where drug use was discussed and felt that app-related conversations should be incorporated into existing care when possible, as opposed to creating new healthcare visits to facilitate use of the app. Nearly all participants preferred to get clinician support for using apps over using them without support. They desired a trusting, supportive relationship with a clinician who could guide them as they used the app. Participants wanted follow-up support via phone calls or secure messaging because these modes of communication were perceived as convenient and low burden (e.g. no co-pays or appointment travel).
Conclusions:
A user-centered implementation of treatment apps for drug use disorders in primary care will require health systems to design workflows that account for patients’ needs for structure, support, and desire for convenience. Clinical Trial: Not applicable
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