Enhancing MySafeRx Engagement in Opioid Use Disorder

MySafeRx is an integrated mobile platform combining medication adherence monitoring and compassionate, motivational mobile recovery coaching designed for treating opioid use disorder and reducing opioid overdoses. The MySafeRx intervention uses an Android mobile device application to integrate four key components into a novel platform for delivering remote, directly observed medication adherence monitoring of Buprenorphine (BUP) to individuals with opioid use disorder. These key components include the following: (1) mobile-based, confidential text messaging; (2) a secure electronic pill organizer system; (3) videoconference-based coaching with daily brief motivational interventions using humanistic, empathic and compassionate motivational interviewing techniques, and 4) a standardized protocol for supervised self-administration of medication and notification of clinicians when medication is not taken. Adherence of buprenorphine is important because as a partial agonist medication, it not only prevents opioid withdrawal, but when taken once daily at the correct dose it also blocks the ability to attain euphoria with other opioids and prevents overdose. By offering a comprehensive, remotely-delivered program for supervised self-administration of medication, this program provides a higher level of care for vulnerable patients during periods of instability or high overdose risk, i.e., transition from inpatient detox or residential treatment back to the community, stabilization on buprenorphine, and/or after lapse to substance use.

The MySafeRx integrated approach is well-liked by patients and demonstrated a 50% reduction in illicit opioid use within just 3 weeks (DOI: 10.1186/s13722-018-0122-4). Yet, some prescribers have difficulty explaining how the program works and showing patients how it will benefit them. For this reason, a multimedia intervention including the use of two videos that are designed to enhance engagement in MySafeRx among patients with opioid use disorder would be strongly welcomed by referring buprenorphine providers. These videos would also support engagement in the ongoing clinical studies of this approach conducted by Cambridge Health Alliance Center for Mindfulness and Compassion affiliated with the Harvard Medical School Department of Psychiatry. Clinical trials are currently underway in Massachusetts/Vermont in collaboration with Geisel School of Medicine at Dartmouth [funded by National Institute of Health/ National Institute for Drug Abuse (NIH/NIDA) (NCT02778282)] and in Florida [funded by the Center for Disease Control (CDC) (1R01CE003039-01)], as well as an ongoing qualitative interview study about the impact of empathic, humanistic coaching on buprenorphine adherence (funded by Russell Berrie Foundation).

With support from the Sandra and Arnold Gold Research Fund, we are developing an animated explainer video and patient experience videos about MySafeRx. These videos are needed to highlight the beneficial effects of mobile recovery coaching with motivational interviewing, to create awareness of this approach, and to explain the different components of the MySafeRx technology platform. These videos can be displayed in detox and residential facilities to patients considering treatment options and can be placed on the MySafeRx website for people considering the treatment option. The videos will assist with the marketing of and recruitment for MySafeRx projects, as well as help to gain attention from prescribers, community members, prospective patients, and potentially loved ones of individuals who have an opioid use disorder who are browsing the MySafeRx website. If MySafeRx continues to be successful in clinical trials, the multimedia intervention will be included as part of a nationwide dissemination of the MySafeRx approach.