Patient Engagement With a Game-Based Digital Therapeutic for the Treatment of Opioid Use Disorder: Protocol for a Randomized Controlled Open-Label, Decentralized Trial

BackgroundPrescription digital therapeutics are software-based disease treatments that are regulated by the US Food and Drug Administration; the reSET-O prescription digital therapeutic was authorized in 2018 and delivers behavioral treatment for individuals receiving bupreno...

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Main Authors: Hilary Luderer, Lisa Chiodo, Amanda Wilson, Christina Brezing, Suky Martinez, Xiaorui Xiong, Robert Gerwien, Bruce Imbert, Mark Deeg, Yuri Maricich, Aimee Campbell
Format: Article
Language:English
Published: JMIR Publications 2022-01-01
Series:JMIR Research Protocols
Online Access:https://www.researchprotocols.org/2022/1/e32759
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author Hilary Luderer
Lisa Chiodo
Amanda Wilson
Christina Brezing
Suky Martinez
Xiaorui Xiong
Robert Gerwien
Bruce Imbert
Mark Deeg
Yuri Maricich
Aimee Campbell
author_facet Hilary Luderer
Lisa Chiodo
Amanda Wilson
Christina Brezing
Suky Martinez
Xiaorui Xiong
Robert Gerwien
Bruce Imbert
Mark Deeg
Yuri Maricich
Aimee Campbell
author_sort Hilary Luderer
collection DOAJ
description BackgroundPrescription digital therapeutics are software-based disease treatments that are regulated by the US Food and Drug Administration; the reSET-O prescription digital therapeutic was authorized in 2018 and delivers behavioral treatment for individuals receiving buprenorphine for opioid use disorder. Although reSET-O improves outcomes for individuals with opioid use disorder, most of the therapeutic content is delivered as narrative text. PEAR-008 is an investigational device based on reSET-O that uses an interactive, game-based platform to deliver similar therapeutic content designed to enhance patient engagement, which may further improve treatment outcomes. ObjectiveWe aim to investigate how participants interact with the prescription digital therapeutic’s new content delivery format. Secondary objectives include evaluating treatment success, symptoms of co-occurring mental health disorders, recovery capital, and skill development. MethodsDue to the COVID-19 pandemic, this study was redesigned using a decentralized model because it was not possible to conduct medication initiation and study visits in person, as initially intended. A decentralized, randomized controlled trial design will be utilized to compare patient engagement with PEAR-008 and that with reSET-O using both subjective and objective assessments. The study population will consist of approximately 130 individuals with opioid use disorder (based on Diagnostic and Statistical Manual of Mental Disorders 5 criteria) who have recently started buprenorphine treatment for opioid use disorder. Participants will be virtually recruited and randomly assigned to receive either PEAR-008 or reSET-O. All study sessions will be virtual, and the duration of the study is 12 weeks. The primary outcome measure of engagement is operationalized as the number of active sessions per week with either PEAR-008 or reSET-O. (An active session is any session that contains some active participation in the app, such as navigating to a different screen, engaging with a learning module, or responding to a notification.) Subjective dimensions of engagement will be assessed with participant surveys. The hypothesis is that PEAR-008 will have significantly greater participant engagement than reSET-O. ResultsAs of February 2021, participant enrollment is ongoing. ConclusionsThis randomized controlled trial will investigate if changing the delivery format and enhancing the content of a prescription digital therapeutic for opioid use disorder will affect how participants use and interact with the prescription digital therapeutic. The study design may serve as a useful model for conducting decentralized studies in this patient population. Trial RegistrationClinicalTrials.gov NCT04542642; https://clinicaltrials.gov/ct2/show/NCT04542642 International Registered Report Identifier (IRRID)DERR1-10.2196/32759
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spelling doaj.art-de5960544fcd4c439af5dbf2161390d62023-08-28T20:26:02ZengJMIR PublicationsJMIR Research Protocols1929-07482022-01-01111e3275910.2196/32759Patient Engagement With a Game-Based Digital Therapeutic for the Treatment of Opioid Use Disorder: Protocol for a Randomized Controlled Open-Label, Decentralized TrialHilary Ludererhttps://orcid.org/0000-0002-3737-946XLisa Chiodohttps://orcid.org/0000-0001-7052-3569Amanda Wilsonhttps://orcid.org/0000-0003-4882-1097Christina Brezinghttps://orcid.org/0000-0002-5888-8685Suky Martinezhttps://orcid.org/0000-0002-4873-8130Xiaorui Xionghttps://orcid.org/0000-0001-7838-4524Robert Gerwienhttps://orcid.org/0000-0001-8368-5188Bruce Imberthttps://orcid.org/0000-0002-0359-6255Mark Deeghttps://orcid.org/0000-0001-6920-9396Yuri Maricichhttps://orcid.org/0000-0001-8667-5233Aimee Campbellhttps://orcid.org/0000-0003-4247-9980 BackgroundPrescription digital therapeutics are software-based disease treatments that are regulated by the US Food and Drug Administration; the reSET-O prescription digital therapeutic was authorized in 2018 and delivers behavioral treatment for individuals receiving buprenorphine for opioid use disorder. Although reSET-O improves outcomes for individuals with opioid use disorder, most of the therapeutic content is delivered as narrative text. PEAR-008 is an investigational device based on reSET-O that uses an interactive, game-based platform to deliver similar therapeutic content designed to enhance patient engagement, which may further improve treatment outcomes. ObjectiveWe aim to investigate how participants interact with the prescription digital therapeutic’s new content delivery format. Secondary objectives include evaluating treatment success, symptoms of co-occurring mental health disorders, recovery capital, and skill development. MethodsDue to the COVID-19 pandemic, this study was redesigned using a decentralized model because it was not possible to conduct medication initiation and study visits in person, as initially intended. A decentralized, randomized controlled trial design will be utilized to compare patient engagement with PEAR-008 and that with reSET-O using both subjective and objective assessments. The study population will consist of approximately 130 individuals with opioid use disorder (based on Diagnostic and Statistical Manual of Mental Disorders 5 criteria) who have recently started buprenorphine treatment for opioid use disorder. Participants will be virtually recruited and randomly assigned to receive either PEAR-008 or reSET-O. All study sessions will be virtual, and the duration of the study is 12 weeks. The primary outcome measure of engagement is operationalized as the number of active sessions per week with either PEAR-008 or reSET-O. (An active session is any session that contains some active participation in the app, such as navigating to a different screen, engaging with a learning module, or responding to a notification.) Subjective dimensions of engagement will be assessed with participant surveys. The hypothesis is that PEAR-008 will have significantly greater participant engagement than reSET-O. ResultsAs of February 2021, participant enrollment is ongoing. ConclusionsThis randomized controlled trial will investigate if changing the delivery format and enhancing the content of a prescription digital therapeutic for opioid use disorder will affect how participants use and interact with the prescription digital therapeutic. The study design may serve as a useful model for conducting decentralized studies in this patient population. Trial RegistrationClinicalTrials.gov NCT04542642; https://clinicaltrials.gov/ct2/show/NCT04542642 International Registered Report Identifier (IRRID)DERR1-10.2196/32759https://www.researchprotocols.org/2022/1/e32759
spellingShingle Hilary Luderer
Lisa Chiodo
Amanda Wilson
Christina Brezing
Suky Martinez
Xiaorui Xiong
Robert Gerwien
Bruce Imbert
Mark Deeg
Yuri Maricich
Aimee Campbell
Patient Engagement With a Game-Based Digital Therapeutic for the Treatment of Opioid Use Disorder: Protocol for a Randomized Controlled Open-Label, Decentralized Trial
JMIR Research Protocols
title Patient Engagement With a Game-Based Digital Therapeutic for the Treatment of Opioid Use Disorder: Protocol for a Randomized Controlled Open-Label, Decentralized Trial
title_full Patient Engagement With a Game-Based Digital Therapeutic for the Treatment of Opioid Use Disorder: Protocol for a Randomized Controlled Open-Label, Decentralized Trial
title_fullStr Patient Engagement With a Game-Based Digital Therapeutic for the Treatment of Opioid Use Disorder: Protocol for a Randomized Controlled Open-Label, Decentralized Trial
title_full_unstemmed Patient Engagement With a Game-Based Digital Therapeutic for the Treatment of Opioid Use Disorder: Protocol for a Randomized Controlled Open-Label, Decentralized Trial
title_short Patient Engagement With a Game-Based Digital Therapeutic for the Treatment of Opioid Use Disorder: Protocol for a Randomized Controlled Open-Label, Decentralized Trial
title_sort patient engagement with a game based digital therapeutic for the treatment of opioid use disorder protocol for a randomized controlled open label decentralized trial
url https://www.researchprotocols.org/2022/1/e32759
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