JMIR Publications

ABSTRACT

Background:

The United States is facing an opioid overdose epidemic resulting in an unprecedented number of preventable deaths. The use of medications including buprenorphine and methadone have proven effective for opioid use disorder (OUD), but many patients struggle to stay in treatment. Novel solutions, such as digital health tools, offer options to increase retention in treatment, maximize treatment benefits, and prevent overdose deaths.

Objective:

Using a mixed methods approach, we investigated facilitators and barriers to utilization of a third-party digital health platform called Opioid Addiction Recovery Support (OARS) to aid OUD treatment engagement and adherence in a primary care setting.

Methods:

Patient and provider utilization of OARS was observed for ten months and summarized using descriptive statistics. Differences in utilization were assessed using Wilcoxon signed rank tests. Additionally, key informant interviews were conducted with providers that prescribe medication for opioid use disorder (MOUD) and their support staff to understand the facilitators and barriers to implementation. Qualitative data were analyzed using a Coding Reliability Thematic Analysis approach.

Results:

Among 205 MOUD patients invited to use OARS, 158 patients signed up and 60 used it more than once. Patients whose provider had entered their information into OARS viewed test results (p<0.05), progress (p<0.01), and educational content (p<0.05) more days than patients without information in OARS. There was no difference in OARS utilization for patients who were and were not actively engaged in MOUD treatment. Providers and support staff reported that OARS increased patient-provider communication and allowed patients to better track their overall MOUD treatment. They also recognized challenges in integrating OARS with the electronic health record (EHR).

Conclusions:

Findings from this study suggest that digital health tools can be beneficial for both patients and providers because they have the potential to increase patient-provider communication, support patients’ ability to track their own progress, and enhance providers’ ability to identify patients at risk for relapse. The primary barrier to utilization for providers was the lack of integration between OARS and the EHR. Future research is needed to determine ways to routinize use of digital health tools in MOUD treatment, primarily by solving technical and organizational challenges associated with EHR integration. Findings show digital health tools do not diminish outcomes when implemented in opioid treatment clinics.