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A Mobile Health App to Support Patients Receiving Medication-Assisted Treatment for Opioid Use Disorder: Development and Feasibility Study.
JMIR Form Res. 2021 Feb 23; 5(2):e24561.JF

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 for the treatment of OUD that relies on a combination of behavioral therapy and medication. Less than half of those living with OUD are accessing this treatment. Mobile technology can enhance the treatment of chronic diseases in readily accessible and cost-effective ways through self-monitoring and support.

OBJECTIVE

The aim of this study is to describe the adaptation of a mobile platform for patients undergoing 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 included semistructured interviews to understand the needs of patients with OUD, providers' perspectives, and opportunities for MAT support via a mobile app. A second round of formative interviews used mock-ups of app features to collect feedback on feature function and desirability. Formative participants' input from 16 interviews then informed the development of a functional smartphone app. Patient participants (n=25) and provider participants (n=3) were enrolled in a 6-month pilot study of the completed platform. Patient app use and usability interviews, including a system usability score and open-ended questions, were completed 1 month into the pilot study. Open-ended responses were analyzed for prevalent themes.

RESULTS

Formative interviews resulted in the development of a mobile app, named HOPE, which includes both evidence-based and participant-suggested features. The 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. Patients and providers reported high levels of system usability (mean 86.9, SD 10.2 and mean 83.3, SD 12.8, respectively). Qualitative analysis of open-ended usability questions highlighted the value of self-monitoring, access to support through the app, and perceived improvement in connection to care and communication for both patient and provider participants.

CONCLUSIONS

The use of the HOPE program by pilot participants, high 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 a web portal that was highly usable and acceptable to study participants. Further work is needed to understand the program's effect on clinical outcomes, patient linkage, and engagement in care.

Authors+Show Affiliations

Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.University of Virginia School of Medicine, Charlottesville, VA, United States.Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.Department of Psychiatry and Neurobehavioral Sciences, Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, VA, United States.Department Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States.Department Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States.Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33620324

Citation

Waselewski, Marika Elise, et al. "A Mobile Health App to Support Patients Receiving Medication-Assisted Treatment for Opioid Use Disorder: Development and Feasibility Study." JMIR Formative Research, vol. 5, no. 2, 2021, pp. e24561.
Waselewski ME, Flickinger TE, Canan C, et al. A Mobile Health App to Support Patients Receiving Medication-Assisted Treatment for Opioid Use Disorder: Development and Feasibility Study. JMIR Form Res. 2021;5(2):e24561.
Waselewski, M. E., Flickinger, T. E., Canan, C., Harrington, W., Franklin, T., Otero, K. N., Huynh, J., Waldman, A. L. D., Hilgart, M., Ingersoll, K., Ait-Daoud Tiouririne, N., & Dillingham, R. A. (2021). A Mobile Health App to Support Patients Receiving Medication-Assisted Treatment for Opioid Use Disorder: Development and Feasibility Study. JMIR Formative Research, 5(2), e24561. https://doi.org/10.2196/24561
Waselewski ME, et al. A Mobile Health App to Support Patients Receiving Medication-Assisted Treatment for Opioid Use Disorder: Development and Feasibility Study. JMIR Form Res. 2021 Feb 23;5(2):e24561. PubMed PMID: 33620324.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Mobile Health App to Support Patients Receiving Medication-Assisted Treatment for Opioid Use Disorder: Development and Feasibility Study. AU - Waselewski,Marika Elise, AU - Flickinger,Tabor Elisabeth, AU - Canan,Chelsea, AU - Harrington,William, AU - Franklin,Taylor, AU - Otero,Kori Nicole, AU - Huynh,Jacqueline, AU - Waldman,Ava Lena Davila, AU - Hilgart,Michelle, AU - Ingersoll,Karen, AU - Ait-Daoud Tiouririne,Nassima, AU - Dillingham,Rebecca Anne, Y1 - 2021/02/23/ PY - 2020/09/29/received PY - 2021/01/15/accepted PY - 2021/01/01/revised PY - 2021/2/23/entrez PY - 2021/2/24/pubmed PY - 2021/2/24/medline KW - mHealth KW - mobile phone KW - opioid use disorder KW - opioids KW - public health KW - retention in care KW - self-management SP - e24561 EP - e24561 JF - JMIR formative research JO - JMIR Form Res VL - 5 IS - 2 N2 - 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 for the treatment of OUD that relies on a combination of behavioral therapy and medication. Less than half of those living with OUD are accessing this treatment. Mobile technology can enhance the treatment of chronic diseases in readily accessible and cost-effective ways through self-monitoring and support. OBJECTIVE: The aim of this study is to describe the adaptation of a mobile platform for patients undergoing 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 included semistructured interviews to understand the needs of patients with OUD, providers' perspectives, and opportunities for MAT support via a mobile app. A second round of formative interviews used mock-ups of app features to collect feedback on feature function and desirability. Formative participants' input from 16 interviews then informed the development of a functional smartphone app. Patient participants (n=25) and provider participants (n=3) were enrolled in a 6-month pilot study of the completed platform. Patient app use and usability interviews, including a system usability score and open-ended questions, were completed 1 month into the pilot study. Open-ended responses were analyzed for prevalent themes. RESULTS: Formative interviews resulted in the development of a mobile app, named HOPE, which includes both evidence-based and participant-suggested features. The 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. Patients and providers reported high levels of system usability (mean 86.9, SD 10.2 and mean 83.3, SD 12.8, respectively). Qualitative analysis of open-ended usability questions highlighted the value of self-monitoring, access to support through the app, and perceived improvement in connection to care and communication for both patient and provider participants. CONCLUSIONS: The use of the HOPE program by pilot participants, high 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 a web portal that was highly usable and acceptable to study participants. Further work is needed to understand the program's effect on clinical outcomes, patient linkage, and engagement in care. SN - 2561-326X UR - https://www.unboundmedicine.com/medline/citation/33620324/A_Mobile_Health_App_to_Support_Patients_Receiving_Medication_Assisted_Treatment_for_Opioid_Use_Disorder:_Development_and_Feasibility_Study_ L2 - https://formative.jmir.org/2021/2/e24561/ DB - PRIME DP - Unbound Medicine ER -