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Reward-based technology to improve opioid use disorder treatment initiation after an ED visit

Award Information
Agency: Department of Health and Human Services
Branch: National Institutes of Health
Contract: 4R42DA049448-02
Agency Tracking Number: R42DA049448
Amount: $1,515,991.00
Phase: Phase II
Program: STTR
Solicitation Topic Code: NIDA
Solicitation Number: PA20-272
Solicitation Year: 2020
Award Year: 2021
Award Start Date (Proposal Award Date): 2021-06-01
Award End Date (Contract End Date): 2024-05-31
Small Business Information
Rindge, NH 03461-5305
United States
DUNS: 116764026
HUBZone Owned: No
Woman Owned: No
Socially and Economically Disadvantaged: No
Principal Investigator
 (508) 334-3817
Business Contact
Phone: (646) 660-2151
Research Institution
WORCESTER, MA 01655-0002
United States

 Nonprofit College or University

Project Summary/Abstract
Millions of people in the US misuse opioids each year, leading to thousands of deaths and billions of dollars in
total economic burden. Medications for opioid use disorder (MOUD) are highly efficacious, but only a fraction of
people with Opioid Use Disorder (OUD) access MOUD, and further treatment non-adherence is common and is
associated with poor outcomes. This application will extend the scope of our parent R42 Opioid Addiction
Recovery Support with Contingency Management (OARS+CM) study assessing the impact of OARS+CM
technology on MOUD treatment initiation and adherence by expanding enrollment sites to include additional EDs
and inpatient psychiatric and detox facilities to reach the sample size needed to adequately analyze the data.
Expansion is necessary as volume at the current enrollment sites are lower than predicted. In the parent grant,
the project enhanced the Opioid Addiction Recovery Support (OARS) application by adding an evidence-based
reward, contingency management (CM) function. CM interventions systematically reward (reinforce) specific
behaviors like treatment initiation and adherence with therapy attendance and drug-free urine tests and are
highly efficacious. An OARS solution enhanced with a CM component (OARS+CM) that allows for the automatic
calculation, delivery, and redemption of rewards contingent on objective evidence of treatment behaviors may
be key to improving MOUD initiation and adherence. After Phase 1 of the parent grant, the existing OARS
clinician portal and patient mobile application was modified to accommodate entry into the software system from
an acute care setting and to automatically manage and deliver rewards to create OARS+CM using patient-
centered design principles. Usability sessions with OUD patients and other key stakeholders informed design.
Primary usability outcomes were examined, and the program iteratively updated. Upon meeting milestones, there
was proof-of-concept pilot of usability, acceptability, and effects on initial behavior targets with 10 patients.
Currently in Phase 2, an RCT is in progress, in which acute care OUD patients appropriate for outpatient MOUD
(N = 102) are recruited and allocated to one of two study conditions: 1) treatment as usual (TAU), comprised of
screening, brief intervention, and referral to treatment by a trained clinician with MyMAT, an attentional control
mobile application, and 2) OARS+CM. The active intervention window for the two intervention groups is 12
weeks. Participants are onboarded prior to discharge from acute care settings (i.e., ED, inpatient medical care,
acute psychiatric and detox facilities). In the outpatient MOUD setting, data on treatment adherence and opioid
use will be captured from clinical records for six months. Telephone follow-up assessments and vital statics
registry reviews will be at month 1, month 3 (end-of-study intervention period), and month 6. Primary MOUD
treatment initiation outcomes will be scheduling and completing the MOUD intake. Primary MOUD treatment
outcomes will be sustained abstinence at Month 6 and longest duration of abstinence. Analysis will examine data
on cost avoidance and cost savings through reduced acute care visits between study conditions.

* Information listed above is at the time of submission. *

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