No abstract

Background Opioid use disorders impact the health and well-being of millions of Americans. Buprenorphine and naloxone (BUP and NAL) can reduce opioid overdose deaths, decrease misuse, and improve quality of life. Unfortunately, poor medication adherence is a primary barrier to the long-term efficacy of BUP and NAL. Objective We aimed to examine patient feedback on current and potential features of a Bluetooth-enabled pill bottle cap and associated mobile app for patients prescribed BUP and NAL for an opioid use disorder, and to solicit recommendations for improvement to effectively and appropriately tailor the technology for people in treatment for opioid use disorder. Methods A convenience sample of patients at an opioid use disorder outpatient clinic were asked about medication adherence, opioid cravings, experience with technology, motivation for treatment, and their existent support system through a brief e-survey. Patients also provided detailed feedback on current features and features being considered for inclusion in a technology designed to increase medication adherence (eg, inclusion of a personal motivational factor, craving and stress tracking, incentives, and web-based coaching). Participants were asked to provide suggestions for improvement and considerations specifically applicable to people in treatment for opioid use disorder with BUP and NAL. Results Twenty people with an opioid use disorder who were prescribed BUP and NAL participated (mean age 34, SD 8.67 years; 65% female; 80% White). Participants selected the most useful, second-most useful, and least useful features presented; 42.1% of them indicated that motivational reminders would be most useful, followed by craving and stress tracking (26.3%) and web-based support forums (21.1%). Every participant indicated that they had at least 1 strong motivating factor for staying in treatment, and half (n=10) indicated children as that factor. All participants indicated that they had, at some point in their lives, the most extreme craving a person could have; however, 42.1% indicated that they had no cravings in the last month. Most respondents (73.7%) stated that tracking cravings would be helpful. Most respondents (84.2%) also indicated that they believed reinforcers or prizes would help them achieve their treatment goals. Additionally, 94.7% of respondents approved of adherence tracking to accommodate this feature using smart packaging, and 78.9% of them approved of selfie videos of them taking their medication. Conclusions Engaging patients taking treatment for opioid use disorder with BUP and NAL allowed us to identify preferences and considerations that are unique to this treatment area. As the technology developer of the pill cap and associated mobile app is able to take into consideration or integrate these preferences and suggestions, the smart cap and associated mobile app will become tailored to this population and more useful for them, which may encourage patient use of the smart cap and associated mobile app.

BACKGROUND Opioid use disorders (OUD) impact the health and well-being of millions of Americans. Buprenorphine or buprenorphine/naloxone (BUP/NAL) can reduce opioid overdose deaths, decrease misuse, and improve quality of life. Unfortunately, poor medication adherence is a primary barrier to long-term efficacy of BUP/NAL. OBJECTIVE The intent of this investigation was to examine qualitative and quantitative patient feedback on a Bluetooth-enabled pill bottle cap and associated mobile application for patients prescribed BUP/NAL for an OUD. METHODS A convenience sample at an OUD outpatient clinic were asked about medication adherence, opioid cravings, experience with technology, and their existent support system through a brief, electronic survey. Patients also provided detailed feedback on features being considered for inclusion in a new technology designed to increase medication adherence, such as inclusion of a personal motivational factor, craving and stress tracking, incentives, and virtual coaching. RESULTS Twenty people (n=20) with an OUD who were prescribed BUP/NAL participated. Participants mean age was 34 years, 65% were female, and 80% Caucasian. Participants had the opportunity to select the most useful, second most useful, and least useful features presented; the large majority indicated that motivational reminders would be most useful (42.1%), followed by craving and stress tracking (26.3%) and online support forums (21.1%). CONCLUSIONS Incorporating these suggestions for the described pill-bottle technology may encourage the use of the platform, as well as allow technology developers and BUP/NAL providers to modify this tool for different patient populations. CLINICALTRIAL N/A