Initial Engagement with a Digital Therapeutic within a Substance Use Disorder Clinic

Prajwal Acharya, BS

Massachusetts General Hospital
Initial Engagement with a Digital Therapeutic within a Substance Use Disorder Clinic

Scientific Abstract

Background: Digital therapeutics have the potential to facilitate delivery of evidence-based behavioral health treatment outside of traditional treatment venues. However, effective treatment requires adoption and engagement with the therapeutic. At the West End Clinic (an outpatient dual-diagnosis clinic for adults at Massachusetts General Hospital), clinicians referred patients to engage with a mobile app that delivers a cognitive behavior therapy protocol for substance use disorders, supported by contingency management and opportunities to report lapses in sobriety, cravings, and medication usage. Here we characterize patients who were successfully enrolled in the app.

Methods: This retrospective quality assessment study examined characteristics of patients and treatment for individuals referred to the digital health app at the West End Clinic. Patient engagement were assessed looking at a clinician dashboard made available through the app. Patient demographics, diagnoses and patient care characteristics were extracted from the electronic medical record. Relationships between covariates and signup were assessed both qualitatively and by using logistic regression analysis.

Results: Among 48 patients referred to the digital app, 25 completed sign up (52%). No relationship was qualitatively observed between successful enrollment with patient age, gender, insurance type, presence of opioid use disorder diagnosis, presence of alcohol use disorder diagnosis, or duration in clinic before referral. This lack of relationship was supported by relatively weak coefficients in a logistic regression.

Conclusions: Based on preliminary data from one clinic implementing a digital therapeutic app to complement traditional care, we could not identify characteristics of patients, their illness or their treatment that suggested bias in who would activate the app. This may suggest that clinicians should not alter expectations around initial engagement with digital therapeutics according to the quality of the patients (e.g., age). Further analyses can explore other factors that may pertain to initial engagement or can examine continued engagement with digital therapeutics.

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Prajwal Acharya, BS, Vinod Rao MD PhD