Polysubstance use involving opioids and methamphetamine is emerging as a new public health crisis. Patients with opioids and methamphetamine use often experience serious medical complications requiring hospitalization, which provides an opportunity to offer addiction treatment. Yet linkage to outpatient treatment post-discharge is suboptimal and methamphetamine exacerbates outcomes. The investigators propose to pilot test "MHealth Incentivized Adherence Plus Patient Navigation" (MIAPP) to promote treatment linkage and retention for patients with opioid use disorder (OUD) and methamphetamine use who initiate buprenorphine in the hospital. The investigators Aim is to perform a two-arm, pilot randomized clinical trial (n=40) comparing MIAPP + treatment-as-usual (TAU) versus TAU alone on outpatient medication for opioid use disorder (MOUD) linkage within 30 days (primary) and 90-day retention on medications (secondary) among hospitalized patients with OUD and methamphetamine use.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
Intervention consists of patient navigation with the mHealth adherence application facilitating telehealth visits, two-way chats, video-DOT, and delivery of financial incentives via smartphone.
Harborview Medical Center
Seattle, Washington, United States
Patient linkage to an outpatient program that provides medication for opioid use disorder
Defined as documentation of an outpatient clinical encounter (either in-person or via telemedicine) where a medication for OUD (either buprenorphine, naltrexone, or methadone) was provided or prescribed.
Time frame: 30 days post-discharge from hospital
Retention on medication for opioid use disorder
This will be measured as the number of days with medication coverage. (buprenorphine, naltrexone, or methadone).
Time frame: 90 days post-discharge from hospital
Hospital readmission
The number of hospital admissions will be extracted from statewide Medicaid claims data.
Time frame: 90 days post-discharge from hospital
Emergency department visits
The number of emergency department visits will be extracted from statewide Medicaid claims data.
Time frame: 90 days post-discharge from hospital
Past 30-day opioid use
The number of days using illicit opioids in the past 30 days per self-report as collected through the modified Addiction Severity Index.
Time frame: 30 days post-discharge
Past 30-day methamphetamine use
The number of days using methamphetamine in the past 30 days per self-report as collected through the modified Addiction Severity Index.
Time frame: 30 days post-discharge
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