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Tofighi B, Badiei B, Badolato R, Lewis CF, Nunes E, Thomas A, Lee JD. Integrating Text Messaging in a Low Threshold Telebuprenorphine Program for New York City Residents with Opioid Use Disorder during COVID-19: A Pilot Randomized Controlled Trial. J Addict Med 2023; 17:e281-e286. [PMID: 37788603 PMCID: PMC10544683 DOI: 10.1097/adm.0000000000001161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
BACKGROUND Pragmatic innovations are needed to optimize clinical outcomes among people who use opioids initiating buprenorphine. This pilot randomized controlled trial assessed the feasibility of integrating text messaging in a low threshold telebuprenorphine bridge program for people who use opioids during the COVID-19 pandemic. METHODS Eligible adult patients with opioid use disorder inducted on buprenorphine (N = 128) in the NYC Health+Hospitals Virtual Buprenorphine Clinic between May and November 2020 were randomized to an automated texting intervention based on the medical management model versus treatment as usual. A participant feedback survey was administered at 8 weeks (n = 18). Primary outcomes consisted of acceptability (eg, study enrollment, engagement with the intervention) and feasibility (eg, lack of phone number and/or mobile phone ownership) of integrating texting in clinical care. A secondary outcome included retention in treatment at week 8 (ie, active buprenorphine prescription within the prior 7 days). RESULTS Nearly all eligible patients consented to enroll in the study (90.8%) and few were excluded because of lack of mobile phone ownership (n = 27, 14.6%). Requests to discontinue receipt of texts (n = 6, 9.4%) was attributed to excessive message frequency, perceived lack of relevancy, and reduced interest in the intervention. Respondents completing the follow-up feedback survey were generally satisfied with the frequency of software-generated messages (14/18, 77.8%) and half shared text content with peers (9/18, 50%). There were no perceived issues with privacy, intrusiveness, or ease of use. Retention did not differ between participants randomized to the texting (M = 5.23 weeks, SD = 3.41) and treatment as usual groups (M = 4.98 weeks, SD = 3.34) at week 8 ( P = 0.676). CONCLUSIONS This pilot randomized controlled trial confirms high acceptability and feasibility of integrating an automated texting tool in a telebuprenorphine bridge program. Future studies should assess whether text messaging may be efficacious when combined with staff contact and content addressing social determinants of health.
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Affiliation(s)
- Babak Tofighi
- Nathan S. Kline Institute for Psychiatric Research, Division of Social Solutions and Services Research, Center for Research on Cultural & Structural Equity in Behavioral Health
- New York University School of Medicine, Department of Population Health
- Center for Drug Use and HIV Research, NYU College of Global Public Health
| | - Beita Badiei
- New York University School of Medicine, Department of Population Health
| | - Ryan Badolato
- New York University School of Medicine, Department of Psychiatry
| | - Crystal Fuller Lewis
- Nathan S. Kline Institute for Psychiatric Research, Division of Social Solutions and Services Research, Center for Research on Cultural & Structural Equity in Behavioral Health
- New York University School of Medicine, Department of Psychiatry
| | - Edward Nunes
- Columbia University Medical Center, Department of Psychiatry
| | - Anil Thomas
- New York University School of Medicine, Department of Psychiatry
| | - Joshua D. Lee
- New York University School of Medicine, Department of Population Health
- Center for Drug Use and HIV Research, NYU College of Global Public Health
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Teck JTW, Zlatkute G, Perez A, Dritschel H, Ghosh A, Potenza MN, Ambekar A, Ekhtiari H, Stein D, Khazaal Y, Arunogiri S, Torrens M, Ferri M, Galea-Singer S, Baldacchino A. Key implementation factors in telemedicine-delivered medications for opioid use disorder: a scoping review informed by normalisation process theory. Lancet Psychiatry 2023; 10:50-64. [PMID: 36526346 DOI: 10.1016/s2215-0366(22)00374-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 12/23/2022]
Abstract
Telemedicine could improve access to medications for opioid use disorder (MOUD). Telemedicine-delivered MOUD (TMOUD) has expanded substantially in response to the restrictions imposed by the COVID-19 pandemic on in-person clinical contact, yet this expansion has not happened consistently across all health systems and countries. This Review aims to understand key factors in TMOUD implementation that might explain variations in uptake. We did a scoping review using three English language databases for articles reporting on the implementation of TMOUD services. 57 peer-reviewed articles were identified, subjected to open coding and thematic analysis, and further interpreted through normalisation process theory (NPT). NPT was originally used to evaluate telehealth innovations and has been applied extensively to describe, assess, and develop the implementation potential of a broad range of complex health-care interventions. By categorising our findings according to the four core NPT constructs of coherence, cognitive participation, collective action, and reflexive monitoring, we aim to rationalise the current evidence base to show the workability of TMOUD in practice. We find that variations in TMOUD models in practice depend on organisations' attitudes towards risk, clinicians' tensions around giving up control over standard practices, organisation-level support in overcoming operational and technological challenges, and evaluation methods that might neglect a potential widening of the digital divide.
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Affiliation(s)
- Joseph Tay Wee Teck
- DigitAS Project, Population and Behavioural Science, School of Medicine, University of St Andrews, St Andrews, UK; Forward Leeds and Humankind Charity, Durham, UK.
| | - Giedre Zlatkute
- DigitAS Project, Population and Behavioural Science, School of Medicine, University of St Andrews, St Andrews, UK
| | - Alberto Perez
- DigitAS Project, Population and Behavioural Science, School of Medicine, University of St Andrews, St Andrews, UK
| | - Heidi Dritschel
- DigitAS Project, Population and Behavioural Science, School of Medicine, University of St Andrews, St Andrews, UK
| | - Abhishek Ghosh
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA; the Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Atul Ambekar
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | | | - Dan Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Yasser Khazaal
- Addiction Medicine, Lausanne University Hospital, Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland; Research Center, Institute of Mental Health, Montréal University, Montréal, QC, Canada
| | - Shalini Arunogiri
- Monash Addiction Research Centre, Eastern Health Clinical School, Melbourne, VIC, Australia
| | - Marta Torrens
- School of Medicine, Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Barcelona, Spain
| | - Marica Ferri
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Susanna Galea-Singer
- DigitAS Project, Population and Behavioural Science, School of Medicine, University of St Andrews, St Andrews, UK; NHS Fife Addiction Services, Leven, UK
| | - Alex Baldacchino
- DigitAS Project, Population and Behavioural Science, School of Medicine, University of St Andrews, St Andrews, UK
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Kiburi SK, Ngarachu E, Tomita A, Paruk S, Chiliza B. Digital interventions for opioid use disorder treatment: A systematic review of randomized controlled trials. J Subst Abuse Treat 2023; 144:108926. [PMID: 36356329 DOI: 10.1016/j.jsat.2022.108926] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 09/05/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Opioid use disorders are associated with a high burden of disease and treatment gap. Digital interventions can be used to provide psycho-social treatment for opioid use disorders, as an alternative to or together with face-to-face interventions. This review aimed to assess the application and effectiveness of digital interventions to treat opioid use disorder globally. METHODS The study team searched four electronic databases (PubMed, Psych INFO, Web of Science and Cochrane Central register of controlled trials). The inclusion criteria were: randomized controlled trials, assessment for opioid use before and at least once following intervention, and use of digital interventions. The primary outcomes were opioid use and/or retention in treatment, with data being summarized in tables and a narrative review presented. RESULTS The initial database search yielded 3542 articles, of which this review includes 20. Nineteen were conducted among adults in the United States. The digital interventions used included web-based, computer-based, telephone calls, video conferencing, automated self-management system, mobile applications and text messaging. They were based on therapeutic education systems, community reinforcement approaches, cognitive behavior therapy, relapse prevention, brief interventions, supportive counselling and motivational interviewing. The studies had mixed findings; of the 20 studies, 10 had statistically significant differences between the treatment groups for opioid abstinence, and four had significant differences for treatment retention. Comparisons were difficult due to varying methodologies. Participants rated the interventions as acceptable and reported high rates of satisfaction. CONCLUSION The use of digital interventions for opioid use disorder treatment was acceptable, with varying levels of effectiveness for improving outcomes, which is influenced by participant and intervention delivery factors. Further studies in different parts of the world should compare these findings, specifically in low- and middle-income countries.
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Affiliation(s)
- Sarah Kanana Kiburi
- Discipline of Psychiatry, Nelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa; Department of Psychiatry, Mbagathi Hospital, Nairobi, Postal address P.O. Box 20725-00202, Nairobi, Kenya.
| | - Elizabeth Ngarachu
- Department of Psychiatry, Mathari Teaching and Referral Hospital, Nairobi, Kenya
| | - Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa; KwaZulu-Natal Research Innovation and Sequencing Platform, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
| | - Saeeda Paruk
- Discipline of Psychiatry, Nelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Bonginkosi Chiliza
- Discipline of Psychiatry, Nelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa.
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Hsu M, Martin B, Ahmed S, Torous J, Suzuki J. Smartphone Ownership, Smartphone Utilization, and Interest in Using Mental Health Apps to Address Substance Use Disorders: Literature Review and Cross-sectional Survey Study Across Two Sites. JMIR Form Res 2022; 6:e38684. [PMID: 35797102 PMCID: PMC9305402 DOI: 10.2196/38684] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/10/2022] [Accepted: 06/21/2022] [Indexed: 01/25/2023] Open
Abstract
Background In recent years, there has been increasing interest in implementing digital technologies to diagnose, monitor, and intervene in substance use disorders. Smartphones are now a vehicle for facilitating telepsychiatry visits, measuring health metrics, and communicating with health care professionals. In light of the COVID-19 pandemic and the movement toward web-based and hybrid clinic visits and meetings, it has become especially salient to assess phone ownership among individuals with substance use disorders and their comfort in navigating phone functionality and using phones for mental health purposes. Objective The aims of this study were to summarize the current literature around smartphone ownership, smartphone utilization, and the acceptability of using smartphones for mental health purposes and assess these variables across two disparate substance use treatment sites. Methods We performed a focused literature review via a search of two academic databases (PubMed and Google Scholar) for publications since 2007 on the topics of smartphone ownership, smartphone utilization, and the acceptability of using mobile apps for mental health purposes among the substance use population. Additionally, we conducted a cross-sectional survey study that included 51 participants across two sites in New England—an inpatient detoxification unit that predominantly treats patients with alcohol use disorder and an outpatient methadone maintenance treatment clinic. Results Prior studies indicated that mobile phone ownership among the substance use population between 2013 and 2019 ranged from 83% to 94%, while smartphone ownership ranged from 57% to 94%. The results from our study across the two sites indicated 96% (49/51) mobile phone ownership and 92% (47/51) smartphone ownership among the substance use population. Although most (43/49, 88%) patients across both sites reported currently using apps on their phone, a minority (19/48, 40%) reported previously using any apps for mental health purposes. More than half of the participants reported feeling at least neutrally comfortable with a mental health app gathering information regarding appointment reminders (32/48, 67%), medication reminders (33/48, 69%), and symptom surveys (26/45, 58%). Most patients were concerned about privacy (34/51, 67%) and felt uncomfortable with an app gathering location (29/47, 62%) and social (27/47, 57%) information for health care purposes. Conclusions The majority of respondents reported owning a mobile phone (49/51, 96%) and smartphone (47/51, 92%), consistent with prior studies. Many respondents felt comfortable with mental health apps gathering most forms of personal information and with communicating with their clinician about their mental health. The differential results from the two sites, namely greater concerns about the cost of mental health apps among the methadone maintenance treatment cohort and less experience with downloading apps among the older inpatient detoxification cohort, may indicate that clinicians should tailor technological interventions based on local demographics and practice sites and that there is likely not a one-size-fits-all digital psychiatry solution.
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Affiliation(s)
- Michael Hsu
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States
| | - Bianca Martin
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States
| | - Saeed Ahmed
- West Ridge Center, Rutland Regional Medical Center, Rutland, VT, United States
| | - John Torous
- Digital Psychiatry Division, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Joji Suzuki
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States
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5
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Ganesh R, Rao R, Deb KS, Bhad R, Yadav D. Digital Capacity and Interest in mHealth Interventions Among Individuals on Opioid Agonist Maintenance Treatment: A Cross-Sectional Community-Based Study. Indian J Psychol Med 2022; 44:354-358. [PMID: 35949629 PMCID: PMC9301754 DOI: 10.1177/02537176211027239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Integrating mobile technologies in healthcare (mHealth) is helpful to manage various medical conditions. mHealth applications can bridge the gap in the management of patients with opioid use disorder (OUD). Research evaluating the feasibility of mHealth to address OUD is limited in developing countries. We aimed to assess the digital capacity and interest in mHealth interventions in patients maintained on opioid agonist treatment (OAT). METHODS 150 patients on OAT from a community drug treatment clinic in New Delhi, India, were included. We assessed the participants on their pattern of mobile and Internet use and their willingness to use mHealth technology to access health information and services related to OUD. RESULTS 88% of participants (n = 132) owned a mobile phone at assessment; 2.7% (n = 4) had never used a mobile phone in their lifetime. 70% (n = 105) participants had Internet access. 80% (n = 120) of participants showed interest in receiving text messages related to the management of OUD. 60% of participants showed a willingness to download and use applications for monitoring their substance use. CONCLUSIONS In India, there is an interest among people on OAT to use mHealth interventions to manage their substance use. This population also has access to mobile phones and the necessary knowledge to install and run applications needed for various mHealth interventions.
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Affiliation(s)
- Ragul Ganesh
- Dept. of Psychiatry and National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ravindra Rao
- Dept. of Psychiatry and National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Koushik Sinha Deb
- Dept. of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Roshan Bhad
- Dept. of Psychiatry and National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Deepak Yadav
- Dept. of Psychiatry and National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Tofighi B, Durr M, Marini C, Lewis CF, Lee JD. A Mixed-Methods Evaluation of the Feasibility of a Medical Management-Based Text Messaging Intervention Combined With Buprenorphine in Primary Care. Subst Abuse 2022; 16:11782218221078253. [PMID: 35356483 PMCID: PMC8958716 DOI: 10.1177/11782218221078253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/17/2022] [Indexed: 11/15/2022]
Abstract
Background: Mobile health (mHealth) tools offer an effective and personalized approach to enhance chronic disease management and may partially offset provider-level barriers to increasing buprenorphine prescribing in primary care. This study assessed the feasibility of integrating a text messaging-based medical management tool (TeMeS) in primary care among patients initiating buprenorphine. Methods: TeMeS messages are categorized per the medical management model, programed in a HIPAA-compliant texting software (Apptoto©), and delivered in a tiered fashion over 8-weeks to patients. This mixed-methods evaluation of TeMeS utilized key stakeholder feedback (patients, physicians, administrators, nursing), text messaging software process measures, thematic analysis of patient participant text message content, and electronic administrative data (eg, appointment adherence, treatment retention) at 2-months. Results: The study team approached 65 patients and n = 14 (21%) were ineligible or declined to participate in the study. Most eligible participants owned a smartphone (90%), responded to at least one text query (88%) over an average of 24 days, and few requested to stop receiving texts (6%). Participant text replies included responses to cognitive behavioral therapy-based queries (13.8%), confirming or rescheduling appointments (6.1%), and insurance, pharmacy, or clinical issues pertaining to buprenorphine dispensation or dosing (2%). Suggestions for design modifications included personalizing message content and adjusting message frequency per patient risk of illicit opioid reuse, use of video-based informational content, and real-time provider and staff support for emergent issues. Conclusion: Our findings highlight the acceptability, feasibility, and high rates of engagement of utilizing text messaging to enhance self-management among patients initiating buprenorphine treatment.
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Affiliation(s)
- Babak Tofighi
- Nathan S. Kline Institute for Psychiatric Research, Division of Social Solutions and Services Research, Center for Research on Cultural & Structural Equity in Behavioral Health, New York, NY, USA
- Department of Population Health, New York University School of Medicine, New York, NY, USA
- Center for Drug Use and HIV Research, NYU College of Global Public Health, New York, NY, USA
- Babak Tofighi, Department of Population Health, New York University School of Medicine, 180 Madison Avenue, Room 17-13, New York, NY 10016, USA.
| | - Meghan Durr
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Christina Marini
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Crystal F Lewis
- Nathan S. Kline Institute for Psychiatric Research, Division of Social Solutions and Services Research, Center for Research on Cultural & Structural Equity in Behavioral Health, New York, NY, USA
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Joshua D Lee
- Department of Population Health, New York University School of Medicine, New York, NY, USA
- Center for Drug Use and HIV Research, NYU College of Global Public Health, New York, NY, USA
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Acceptability and Feasibility of a Mobile Health Application for Video Directly Observed Therapy of Buprenorphine for Opioid Use Disorders in an Office-based Setting. J Addict Med 2021; 14:319-325. [PMID: 31972762 DOI: 10.1097/adm.0000000000000608] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION/BACKGROUND Video directly observed therapy (video-DOT) through a mobile health platform may improve buprenorphine adherence and decrease diversion. This pilot study tested the acceptability and feasibility of using this technology among patients receiving buprenorphine in an office-based setting. METHODS Participants were instructed to record videos of themselves taking buprenorphine. Data were collected from weekly in-person visits over a 4-week period; assessments included self-report of medication adherence, substance use, satisfaction with treatment and use of the application, and also urine drug testing. Open-ended questions at the final visit solicited feedback on patients' experiences using the mobile health application. RESULTS The sample consisted of 14 patients; a majority were male (86%) and White (79%). All participants except 1 (93%) were able to use the application successfully to upload videos. Among those who successfully used the application, the percentage of daily videos uploaded per participant ranged from 18% to 96%; on average, daily videos were submitted by participants 72% of the time. Most participants (10/14; 71%) reported being "very satisfied" with the application; of the remaining 4 participants, 2 were "satisfied" and 2 were "neutral." Participants reported liking the accountability and structure of the application provided and its ease of use. Negative feedback included minor discomfort at viewing one's self during recording and the time required. CONCLUSIONS Based on these results, use of a mobile health application for video-DOT of buprenorphine appears feasible and acceptable for patients who are treated in an office-based setting. Further research is needed to test whether use of such an application can improve treatment delivery and health outcomes.
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Tofighi B, Leonard N, Greco P, Hadavand A, Acosta MC, Lee JD. Technology Use Patterns Among Patients Enrolled in Inpatient Detoxification Treatment. J Addict Med 2020; 13:279-286. [PMID: 30589653 DOI: 10.1097/adm.0000000000000494] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Technology-based interventions offer a practical, low-cost, and scalable approach to optimize the treatment of substance use disorders (SUDs) and related comorbidities (HIV, hepatitis C infection). This study assessed technology use patterns (mobile phones, desktop computers, internet, social media) among adults enrolled in inpatient detoxification treatment. METHODS A 49-item, quantitative and qualitative semi-structured survey assessed for demographic characteristics, technology use patterns (ie, mobile phone, text messaging [TM], smart phone applications, desktop computer, internet, and social media use), privacy concerns, and barriers to technology use. We used multivariate logistic regression models to assess the association between respondent demographic and clinical characteristics and their routine use of technologies. RESULTS Two hundred and six participants completed the survey. Nearly all participants reported mobile phone ownership (86%). Popular mobile phone features included TM (96%), web-browsers (81%), and accessing social media (61%). There was high mobile phone (3.3 ± 2.98) and phone number (2.6 ± 2.36) turnover in the preceding 12 months. Nearly half described daily or weekly access to desktop computers (48%) and most reported internet access (67%). Increased smartphone ownership was associated with higher education status (P = 0.022) and homeless respondents were less likely to report mobile phone ownership (P = 0.010) compared to participants with any housing status (ie, own apartment, residing with friends, family, or in a halfway house). Internet search engines were used by some participants (39.4%, 71/180) to locate 12 step support group meetings (37%), inpatient detoxification programs (35%), short- or long-term rehabilitation programs (32%), and outpatient treatment programs (4%). CONCLUSIONS Technology use patterns among this hard-to-reach sample of inpatient detoxification respondents suggest high rates of mobile phone ownership, TM use, and moderate use of technology to facilitate linkage to addiction treatment services.
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Affiliation(s)
- Babak Tofighi
- NYU College of Nursing (NL); NYU Department of Population Health (JDL, BT, PG); Johns Hopkins School of Public Health (AH); National Development and Research Institutes, Inc, New York, NY (MCA)
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Tofighi B, Hein P, Carvalho AMS, Lee JD, Leonard NR. Technology preferences to enhance HIV and HCV care among patients with substance use disorders. J Addict Dis 2019; 37:157-159. [PMID: 31380732 DOI: 10.1080/10550887.2019.1640056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We examined technology use patterns (e.g., mobile phone and computer ownership, text messaging, internet access) and preferences for adopting health information technologies to optimize office-based treatment for substance use disorders, HIV, and Hepatitis C virus (HCV) infection. Surveys were administered to patients enrolled in inpatient detoxification program in a publicly-funded tertiary referral center. Most reported mobile phone ownership (86%) and described high rates of mobile phone (3.3) and phone number (2.6) turnover in the preceding year. Internet access was reported on a daily (52%) or weekly basis (22%). Most participants were amenable to receiving text message-based informational content (i.e., medications, support groups, treatment programs) pertaining to substance use disorders (79%), HIV (50%), and HCV care (58%). Respondents reporting less than high school education and past year incarcerated elicited higher favorability in adopting smartphone apps to facilitate peer sharing of HIV-HCV related content. Results suggest high favorability for adopting health information technologies to enhance office-based treatment for substance use disorders, HIV, and HCV, particularly among vulnerable patient sub-groups.
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Affiliation(s)
- Babak Tofighi
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,Division of General Internal Medicine and Clinical Innovation, New York University School of Medicine, New York, NY, USA.,Center for Drug Use and HIV Research (CDUHR), New York, NY, USA
| | - Paul Hein
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | | | - Joshua D Lee
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,Division of General Internal Medicine and Clinical Innovation, New York University School of Medicine, New York, NY, USA.,Center for Drug Use and HIV Research (CDUHR), New York, NY, USA
| | - Noelle R Leonard
- Center for Drug Use and HIV Research (CDUHR), New York, NY, USA.,NYU College of Nursing, New York, NY, USA
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Tofighi B, Lee JD, Sherman S, Schatz D, El-Shahawy O. Smoking patterns and preferences for technology assisted smoking cessation interventions among adults with opioid and alcohol use disorders. JOURNAL OF SUBSTANCE USE 2019; 24:660-665. [PMID: 32952442 DOI: 10.1080/14659891.2019.1642407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background Smoking remains a major public health burden among persons with opioid and/or alcohol use disorder. Methods A 49-item semi-structured survey was conducted among urban, inpatient detoxification program patients eliciting demographic and clinical characteristics, smoking profile, technology use patterns, and preferences for adopting technology-based smoking cessation interventions. Multivariate logistic regression models further evaluated the association between participant demographic and clinical characteristics and technology preferences. Results Participants were mostly male (91%), and admitted for detoxification for alcohol (47%), heroin (31%), or both alcohol and heroin (22%). Past 30-day smoking was reported by 78% of the sample. Mobile phone ownership was common (89%); with an average past-year turnover of 3 mobile phones and 3 phone numbers. Computer ownership was low (28%) and one third reported daily internet use (34%). Telephone (41%) and text message-based interventions (40%) were the most popular platforms to facilitate smoking cessation. Conclusions Despite concurrent AUD-OUD, most respondents had attempted to quit smoking in the last year and preferred telephone- and text message-based interventions to facilitate smoking cessation. High turnover of mobile phones, phone numbers, and limited access to computers pose barriers to dissemination of technology-based smoking cessation interventions in this vulnerable population.
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Affiliation(s)
- Babak Tofighi
- Department of Population Health, New York University School of Medicine, New York University Abu Dhabi.,Division of General Internal Medicine, New York University School of Medicine, New York University Abu Dhabi.,Department of Psychiatry, New York University School of Medicine, New York University Abu Dhabi
| | - Joshua D Lee
- Department of Population Health, New York University School of Medicine, New York University Abu Dhabi.,Division of General Internal Medicine, New York University School of Medicine, New York University Abu Dhabi.,Department of Psychiatry, New York University School of Medicine, New York University Abu Dhabi
| | - Scott Sherman
- Department of Population Health, New York University School of Medicine, New York University Abu Dhabi.,Division of General Internal Medicine, New York University School of Medicine, New York University Abu Dhabi.,Public Health Research Center, New York University School of Medicine, New York University Abu Dhabi.,VA New York Harbor Healthcare System, New York University School of Medicine
| | - Daniel Schatz
- Department of Population Health, New York University School of Medicine, New York University Abu Dhabi.,Division of General Internal Medicine, New York University School of Medicine, New York University Abu Dhabi
| | - Omar El-Shahawy
- Department of Population Health, New York University School of Medicine, New York University Abu Dhabi.,Public Health Research Center, New York University School of Medicine, New York University Abu Dhabi
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Introduction. Harv Rev Psychiatry 2018; 25:101-102. [PMID: 28475501 DOI: 10.1097/hrp.0000000000000157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tofighi B, Abrantes A, Stein MD. The Role of Technology-Based Interventions for Substance Use Disorders in Primary Care: A Review of the Literature. Med Clin North Am 2018; 102:715-731. [PMID: 29933825 PMCID: PMC6563611 DOI: 10.1016/j.mcna.2018.02.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The burden of alcohol and drug use disorders (substance use disorders [SUDs]) has intensified efforts to expand access to cost-effective psychosocial interventions and pharmacotherapies. This article provides an overview of technology-based interventions (eg, computer-based and Web-based interventions, text messaging, interactive voice recognition, smartphone apps, and emerging technologies) that are extending the reach of effective addiction treatments both in substance use treatment and primary care settings. It discusses the efficacy of existing technology-based interventions for SUDs, prospects for emerging technologies, and special considerations when integrating technologies in primary care (eg, privacy and regulatory protocols) to enhance the management of SUDs.
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Affiliation(s)
- Babak Tofighi
- Department of Population Health, New York University School of Medicine, 227 East 30th Street 7th Floor, New York, NY 10016, USA; Division of General Internal Medicine, New York University School of Medicine, New York, NY 10016, USA.
| | - Ana Abrantes
- Butler Hospital, Department of Psychiatry and Human Behavior, Behavioral Medicine and Addictions Research, Butler, PA, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael D Stein
- Department of Health Law, Policy, and Medicine, Boston University, Boston, MA 02118, USA
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Moore BA, Buono FD, Printz DM, Lloyd DP, Fiellin DA, Cutter CJ, Schottenfeld RS, Barry DT. Customized recommendations and reminder text messages for automated, computer-based treatment during methadone. Exp Clin Psychopharmacol 2017; 25:485-495. [PMID: 29251978 PMCID: PMC5737744 DOI: 10.1037/pha0000149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The Recovery Line is an automated, computer-based intervention based on cognitive behavioral therapy (CBT) designed to provide real-time assistance by phone for patients in methadone maintenance. Preliminary efficacy findings were promising, however, as with other computer-based systems for substance use disorder, patient system use was less than recommended. Development and evaluation of system functions to increase patient engagement and use is needed. Thus, we conducted two randomized trials to evaluate system functions designed to increase patient use of the Recovery Line among methadone-maintained patients with continued illicit drug use. In Trial 1 (n = 60), patients received customized, system use recommendations or no recommendations on each Recovery Line call. Ratings of system usability were higher for customized recommendations (CR), but number of calls and total call time did not differ by condition. Trial 2 evaluated characteristics of reminder messages (message frame and reminder latency). Participants (N = 67) received gain- and loss-frame reminder messages, and were randomly assigned to immediate, short, or long term message latency. Although message framing had no effect, gender interacted with latency condition such that females did not differ by message latency, while males had significantly greater total contact time in the short latency conditions. Number of calls differed by condition over time such that the shorter latencies led to greater calls initially, but dissipated over time. Overall the study indicates that computer-based self-management systems can be adapted to increase patient engagement and use. (PsycINFO Database Record
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Affiliation(s)
- Brent A. Moore
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA, 06511 VA
- Connecticut Healthcare System, West Haven, CT, USA, 06516
- APT Foundation, New Haven, CT, USA 06511
| | - Frank D. Buono
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA, 06511 VA
- Connecticut Healthcare System, West Haven, CT, USA, 06516
- APT Foundation, New Haven, CT, USA 06511
| | - Destiny M.B. Printz
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA, 06511 VA
- Connecticut Healthcare System, West Haven, CT, USA, 06516
- APT Foundation, New Haven, CT, USA 06511
| | - Daniel P. Lloyd
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA, 06511 VA
- APT Foundation, New Haven, CT, USA 06511
| | - David A. Fiellin
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA, 06510
| | - Christopher J. Cutter
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA, 06510
| | | | - Declan T. Barry
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA, 06511 VA
- APT Foundation, New Haven, CT, USA 06511
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Milano G, Saenz E, Clark N, Busse A, Gale J, Campello G, Mattfeld E, Maalouf W, Heikkila H, Martelli A, Morales B, Gerra G. Report on the International Workshop on Drug Prevention and Treatment in Rural Settings Organized by United Nation Office on Drugs and Crime (UNODC) and World Health Organization (WHO). Subst Use Misuse 2017; 52:1801-1807. [PMID: 28605304 DOI: 10.1080/10826084.2017.1306564] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Very little evidence has been reported in literature regarding the misuse of substances in rural areas. Despite the common perception of rural communities as a protective and risk-mitigating environment, the scientific literature demonstrated the existence of many risk factors in rural communities. The Drug Prevention and Health Branch (DHB) of the United Nations Office on Drugs and Crime (UNODC), and the World Health Organization (WHO), in June 2016, organized a meeting of experts in treatment and prevention of SUDs in rural settings. The content presented during the meeting and the related discussion have provided materials for the preparation of an outline document, which is the basis to create a technical tool on SUDs prevention and treatment in rural settings. The UNODC framework for interventions in rural settings is a technical tool aimed to assist policy makers and managers at the national level. This paper is a report on UNODC/WHO efforts to improve the clinical conditions of people affected by SUDs and living in rural areas. The purpose of this article is to draw attention on a severe clinical and social problem in a reality forgotten by everyone.
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Affiliation(s)
- Giulia Milano
- a Department of Internal Medicine , University of Genoa , Genoa , Italy
| | - Elizabeth Saenz
- b Drug Prevention and Health Branch (DHB) , United Nation Office on Drugs and Crime (UNODC) , Vienna , Austria
| | - Nicolas Clark
- c World Health Organization (WHO) , Geneva , Switzerland
| | - Anja Busse
- b Drug Prevention and Health Branch (DHB) , United Nation Office on Drugs and Crime (UNODC) , Vienna , Austria
| | - John Gale
- d Maine Rural Health Research Center , University of Southern Maine , Portland , Maine , USA
| | - Giovanna Campello
- b Drug Prevention and Health Branch (DHB) , United Nation Office on Drugs and Crime (UNODC) , Vienna , Austria
| | - Elizabeth Mattfeld
- b Drug Prevention and Health Branch (DHB) , United Nation Office on Drugs and Crime (UNODC) , Vienna , Austria
| | - Wadih Maalouf
- b Drug Prevention and Health Branch (DHB) , United Nation Office on Drugs and Crime (UNODC) , Vienna , Austria
| | - Hanna Heikkila
- b Drug Prevention and Health Branch (DHB) , United Nation Office on Drugs and Crime (UNODC) , Vienna , Austria
| | | | - Brian Morales
- e Global Drug Demand Reduction Program , United States Department of State , Washington, District of Columbia , USA
| | - Gilberto Gerra
- b Drug Prevention and Health Branch (DHB) , United Nation Office on Drugs and Crime (UNODC) , Vienna , Austria
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15
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Abstract
The deployment of health information technologies promises to optimize clinical outcomes for populations with substance use disorders. Electronic health records, web-based counseling interventions, and mobile phone applications enhance the delivery of evidence-based behavioral and pharmacological treatments, with minimal burden to clinical personnel, infrastructure, and work flows. This clinical case shares a recent experience utilizing mobile phone text messaging between an office-based buprenorphine provider in a safety net ambulatory clinic and a patient seeking buprenorphine treatment for opioid use disorder. The case highlights the use of text message-based physician-patient communication to facilitate unobserved "home" induction onto buprenorphine.
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Tofighi B, Grazioli F, Bereket S, Grossman E, Aphinyanaphongs Y, Lee JD. Text message reminders for improving patient appointment adherence in an office-based buprenorphine program: A feasibility study. Am J Addict 2017; 26:581-586. [PMID: 28799677 DOI: 10.1111/ajad.12557] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 04/20/2017] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Missed visits are common in office-based buprenorphine treatment (OBOT). The feasibility of text message (TM) appointment reminders among OBOT patients is unknown. METHODS This 6-month prospective cohort study provided TM reminders to OBOT program patients (N = 93). A feasibility survey was completed following delivery of TM reminders and at 6 months. RESULTS Respondents reported that the reminders should be provided to all OBOT patients (100%) and helped them to adhere to their scheduled appointment (97%). At 6 months, there were no reports of intrusion to their privacy or disruption of daily activities due to the TM reminders. Most participants reported that the TM reminders were helpful in adhering to scheduled appointments (95%), that the reminders should be offered to all clinic patients (95%), and favored receiving only TM reminders rather than telephone reminders (95%). Barriers to adhering to scheduled appointment times included transportation difficulties (34%), not being able to take time off from school or work (31%), long clinic wait-times (9%), being hospitalized or sick (8%), feeling sad or depressed (6%), and child care (6%). CONCLUSIONS This study demonstrated the acceptability and feasibility of TM appointment reminders in OBOT. Older age and longer duration in buprenorphine treatment did not diminish interest in receiving the TM intervention. Although OBOT patients expressed concern regarding the privacy of TM content sent from their providers, privacy issues were uncommon among this cohort. Scientific Significance Findings from this study highlighted patient barriers to adherence to scheduled appointments. These barriers included transportation difficulties (34%), not being able to take time off from school or work (31%), long clinic lines (9%), and other factors that may confound the effect of future TM appointment reminder interventions. Further research is also required to assess 1) the level of system changes required to integrate TM appointment reminder tools with already existing electronic medical records and appointment records software; 2) acceptability among clinicians and administrators; and 3) financial and resource constraints to healthcare systems. (Am J Addict 2017;26:581-586).
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Affiliation(s)
- Babak Tofighi
- Department of Population Health, New York University School of Medicine, New York, New York.,Division of General Internal Medicine and Clinical Innovation, New York University School of Medicine, New York, New York
| | - Frank Grazioli
- New York University Silver School of Social Work, New York, New York
| | - Sewit Bereket
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Ellie Grossman
- Division of General Internal Medicine and Clinical Innovation, New York University School of Medicine, New York, New York
| | | | - Joshua David Lee
- Department of Population Health, New York University School of Medicine, New York, New York.,Division of General Internal Medicine and Clinical Innovation, New York University School of Medicine, New York, New York
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Tofighi B, Nicholson JM, McNeely J, Muench F, Lee JD. Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature. Drug Alcohol Rev 2017; 36:477-491. [DOI: 10.1111/dar.12535] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/30/2016] [Accepted: 01/14/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Babak Tofighi
- New York University School of Medicine; New York USA
- Department of Population Health; New York University School of Medicine; New York USA
| | - Joseph M. Nicholson
- Division of General Internal Medicine; New York University School of Medicine; New York USA
| | - Jennifer McNeely
- New York University School of Medicine; New York USA
- Department of Population Health; New York University School of Medicine; New York USA
| | - Frederick Muench
- Health Sciences Library; New York University School of Medicine; New York USA
- North Shore Health System; New York USA
| | - Joshua D. Lee
- New York University School of Medicine; New York USA
- Department of Population Health; New York University School of Medicine; New York USA
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Polydorou S, Ross S, Coleman P, Duncan L, Roxas N, Thomas A, Mendoza S, Hansen H. Integrating Buprenorphine Into an Opioid Treatment Program: Tailoring Care for Patients With Opioid Use Disorders. Psychiatr Serv 2017; 68:295-298. [PMID: 27745534 PMCID: PMC5540137 DOI: 10.1176/appi.ps.201500501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This report identifies the institutional barriers to, and benefits of, buprenorphine maintenance treatment (BMT) integration in an established hospital-based opioid treatment program (OTP). METHODS This case study presents the authors' experiences at the clinic, hospital, and corporation levels during efforts to integrate BMT into a hospital-based OTP in New York City and a descriptive quantitative analysis of the characteristics of hospital outpatients treated with buprenorphine from 2006 to 2013 (N=735). RESULTS Integration of BMT into an OTP offered patients the flexibility to transition between intensive structured care and primary care or outpatient psychiatry according to need. Main barriers encountered were regulations, clinical logistics of dispensing medications, internal cost and reimbursement issues, and professional and cultural resistance. CONCLUSIONS Buprenorphine integration offers a model for other OTPs to facilitate partnerships among primary care and mental health clinics to better serve diverse patients with varying clinical needs and with varying levels of social support.
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Affiliation(s)
- Soteri Polydorou
- Dr. Polydorou, Dr. Ross, Dr. Thomas, and Dr. Hansen are with the Department of Psychiatry, where Ms. Duncan was affiliated at the time of this study, Dr. Polydorou is also with the Department of Medicine, Dr. Hansen is also with the Nathan S. Kline Institute for Psychiatric Research, and Ms. Mendoza is with the Department of Psychiatry and Anthropology, where Ms. Roxas was affiliated at the time of this study, all at New York University, New York (e-mail: ). Ms. Duncan is currently a medical student at the University of California San Francisco. Ms. Mendoza is currently a doctoral student at the Columbia University Mailman School of Public Health, New York. Ms. Roxas is currently a medical student at the University of Rochester School of Medicine and Dentistry, Rochester, New York. Mr. Coleman, who is retired, was with the Office of Behavioral Health, New York City Health and Hospitals, New York, at the time of this study
| | - Stephen Ross
- Dr. Polydorou, Dr. Ross, Dr. Thomas, and Dr. Hansen are with the Department of Psychiatry, where Ms. Duncan was affiliated at the time of this study, Dr. Polydorou is also with the Department of Medicine, Dr. Hansen is also with the Nathan S. Kline Institute for Psychiatric Research, and Ms. Mendoza is with the Department of Psychiatry and Anthropology, where Ms. Roxas was affiliated at the time of this study, all at New York University, New York (e-mail: ). Ms. Duncan is currently a medical student at the University of California San Francisco. Ms. Mendoza is currently a doctoral student at the Columbia University Mailman School of Public Health, New York. Ms. Roxas is currently a medical student at the University of Rochester School of Medicine and Dentistry, Rochester, New York. Mr. Coleman, who is retired, was with the Office of Behavioral Health, New York City Health and Hospitals, New York, at the time of this study
| | - Peter Coleman
- Dr. Polydorou, Dr. Ross, Dr. Thomas, and Dr. Hansen are with the Department of Psychiatry, where Ms. Duncan was affiliated at the time of this study, Dr. Polydorou is also with the Department of Medicine, Dr. Hansen is also with the Nathan S. Kline Institute for Psychiatric Research, and Ms. Mendoza is with the Department of Psychiatry and Anthropology, where Ms. Roxas was affiliated at the time of this study, all at New York University, New York (e-mail: ). Ms. Duncan is currently a medical student at the University of California San Francisco. Ms. Mendoza is currently a doctoral student at the Columbia University Mailman School of Public Health, New York. Ms. Roxas is currently a medical student at the University of Rochester School of Medicine and Dentistry, Rochester, New York. Mr. Coleman, who is retired, was with the Office of Behavioral Health, New York City Health and Hospitals, New York, at the time of this study
| | - Laura Duncan
- Dr. Polydorou, Dr. Ross, Dr. Thomas, and Dr. Hansen are with the Department of Psychiatry, where Ms. Duncan was affiliated at the time of this study, Dr. Polydorou is also with the Department of Medicine, Dr. Hansen is also with the Nathan S. Kline Institute for Psychiatric Research, and Ms. Mendoza is with the Department of Psychiatry and Anthropology, where Ms. Roxas was affiliated at the time of this study, all at New York University, New York (e-mail: ). Ms. Duncan is currently a medical student at the University of California San Francisco. Ms. Mendoza is currently a doctoral student at the Columbia University Mailman School of Public Health, New York. Ms. Roxas is currently a medical student at the University of Rochester School of Medicine and Dentistry, Rochester, New York. Mr. Coleman, who is retired, was with the Office of Behavioral Health, New York City Health and Hospitals, New York, at the time of this study
| | - Nichole Roxas
- Dr. Polydorou, Dr. Ross, Dr. Thomas, and Dr. Hansen are with the Department of Psychiatry, where Ms. Duncan was affiliated at the time of this study, Dr. Polydorou is also with the Department of Medicine, Dr. Hansen is also with the Nathan S. Kline Institute for Psychiatric Research, and Ms. Mendoza is with the Department of Psychiatry and Anthropology, where Ms. Roxas was affiliated at the time of this study, all at New York University, New York (e-mail: ). Ms. Duncan is currently a medical student at the University of California San Francisco. Ms. Mendoza is currently a doctoral student at the Columbia University Mailman School of Public Health, New York. Ms. Roxas is currently a medical student at the University of Rochester School of Medicine and Dentistry, Rochester, New York. Mr. Coleman, who is retired, was with the Office of Behavioral Health, New York City Health and Hospitals, New York, at the time of this study
| | - Anil Thomas
- Dr. Polydorou, Dr. Ross, Dr. Thomas, and Dr. Hansen are with the Department of Psychiatry, where Ms. Duncan was affiliated at the time of this study, Dr. Polydorou is also with the Department of Medicine, Dr. Hansen is also with the Nathan S. Kline Institute for Psychiatric Research, and Ms. Mendoza is with the Department of Psychiatry and Anthropology, where Ms. Roxas was affiliated at the time of this study, all at New York University, New York (e-mail: ). Ms. Duncan is currently a medical student at the University of California San Francisco. Ms. Mendoza is currently a doctoral student at the Columbia University Mailman School of Public Health, New York. Ms. Roxas is currently a medical student at the University of Rochester School of Medicine and Dentistry, Rochester, New York. Mr. Coleman, who is retired, was with the Office of Behavioral Health, New York City Health and Hospitals, New York, at the time of this study
| | - Sonia Mendoza
- Dr. Polydorou, Dr. Ross, Dr. Thomas, and Dr. Hansen are with the Department of Psychiatry, where Ms. Duncan was affiliated at the time of this study, Dr. Polydorou is also with the Department of Medicine, Dr. Hansen is also with the Nathan S. Kline Institute for Psychiatric Research, and Ms. Mendoza is with the Department of Psychiatry and Anthropology, where Ms. Roxas was affiliated at the time of this study, all at New York University, New York (e-mail: ). Ms. Duncan is currently a medical student at the University of California San Francisco. Ms. Mendoza is currently a doctoral student at the Columbia University Mailman School of Public Health, New York. Ms. Roxas is currently a medical student at the University of Rochester School of Medicine and Dentistry, Rochester, New York. Mr. Coleman, who is retired, was with the Office of Behavioral Health, New York City Health and Hospitals, New York, at the time of this study
| | - Helena Hansen
- Dr. Polydorou, Dr. Ross, Dr. Thomas, and Dr. Hansen are with the Department of Psychiatry, where Ms. Duncan was affiliated at the time of this study, Dr. Polydorou is also with the Department of Medicine, Dr. Hansen is also with the Nathan S. Kline Institute for Psychiatric Research, and Ms. Mendoza is with the Department of Psychiatry and Anthropology, where Ms. Roxas was affiliated at the time of this study, all at New York University, New York (e-mail: ). Ms. Duncan is currently a medical student at the University of California San Francisco. Ms. Mendoza is currently a doctoral student at the Columbia University Mailman School of Public Health, New York. Ms. Roxas is currently a medical student at the University of Rochester School of Medicine and Dentistry, Rochester, New York. Mr. Coleman, who is retired, was with the Office of Behavioral Health, New York City Health and Hospitals, New York, at the time of this study
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Tofighi B, Grossman E, Bereket S, D Lee J. Text message content preferences to improve buprenorphine maintenance treatment in primary care. J Addict Dis 2015; 35:92-100. [PMID: 26670868 DOI: 10.1080/10550887.2015.1127716] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Few studies have evaluated text message content preferences to support evidence-based treatment approaches for opioid use disorders, and none in primary care office-based buprenorphine treatment settings. This study assessed the acceptability and preferences for a tailored text message intervention in support of core office-based buprenorphine treatment medical management components (e.g., treatment adherence, encouraging abstinence, 12-step group participation, motivational interviewing, and patient-provider communication as needed). There were 97 patients enrolled in a safety net office-based buprenorphine treatment program who completed a 24-item survey instrument that consisted of multiple-choice responses, 7-point Likert-type scales, binomial "Yes/No" questions, and open-ended responses. The sample was predominately male (81%), had an average age of 46 years, and was diverse (64% ethnic/racial minorities); 56% lacked stable employment. Respondents were interested in receiving text message appointment reminders (90%), information pertaining to their buprenorphine treatment (76%), supportive content (70%), and messages to reduce the risk of relapse (88%). Participants preferred to receive relapse prevention text messages during all phases of treatment: immediately after induction into buprenorphine treatment (81%), a "few months" into treatment (57%), and after discontinuing buprenorphine treatment (72%). Respondents also expressed interest in text message content enhancing self-efficacy, social support, and frequent provider communication to facilitate unobserved "home" induction with buprenorphine. Older participants were significantly less receptive to receiving text message appointment reminders; however, they were as interested in receiving supportive, informational, and relapse prevention components compared to younger respondents. Implications for integrating a text message support system in office-based buprenorphine treatment are discussed.
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Affiliation(s)
- Babak Tofighi
- a Department of Population Health , New York University School of Medicine , New York , New York , USA.,b Division of General Internal Medicine, New York University School of Medicine , New York , New York , USA
| | - Ellie Grossman
- b Division of General Internal Medicine, New York University School of Medicine , New York , New York , USA
| | - Sewit Bereket
- a Department of Population Health , New York University School of Medicine , New York , New York , USA
| | - Joshua D Lee
- a Department of Population Health , New York University School of Medicine , New York , New York , USA.,b Division of General Internal Medicine, New York University School of Medicine , New York , New York , USA
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