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HomeHealthcareWhy decentralization and digitization could be the key to unlocking the future...

Why decentralization and digitization could be the key to unlocking the future of addiction care


Addiction care providers are developing digital tools to help decentralize their programs from medical centers. These efforts are aimed at alleviating the numerous access barriers that prevent patients recovering from opioid use disorder from adhering to their treatment plans.

Most programs require patients to travel to medical centers frequently—a significant hurdle for patient groups more likely to have no reliable housing or transportation. To provide an alternative access point and combat the alarming rise in overdose deaths, Charlottesville, Virginia-based UVA Health recently built and deployed an app to help patients recovering from opioid use disorder adhere to treatment.

Many addiction care professionals say the need for digital recovery tools is more urgent than ever as CDC latest data It shows that overdose deaths increased by 15% last year to 107,622. This represents the highest number of overdose deaths recorded in the country in a single 12-month period.

Social workers preselect patients whose circumstances make them most likely to be removed from the treatment plan pilotand patients are actively involved in the design of the inform app.

the application, called hope (Heal Overcome Persist Endure), modeled after positive link, an app developed by the health system to support people living with HIV. HOPE shares key features with PositiveLinks, such as a portal to quickly contact physicians and clinical support staff, a tool to remind users to take their medication and record whether it is taken, and a peer message board for community support and shared education.

Based on feedback from patients recovering from opioid use disorder, the team that developed HOPE added several features to the app. These include tools to track mood and stress levels, a feature that allows users to record moments when they feel encouraged about recovery, and a way to track triggers that increase a user’s desire to use opioids.

Dr. Jacqueline Hodges, an infectious disease physician at UVA Health and a member of the HOPE app development team, said incorporating user feedback into the design process was a key to ensuring the app mitigated the stigma and stigma people face recovering from recovery. Important Approaches to Access Disorders in Opioid Use Disorder.

“We obviously have our own preconceptions about what a recovering person might want or need. It’s not our lived experience, and it’s not something we can really understand on a personal level,” Hodges said. “At the end of the day, the app will only succeed if people think it actually benefits them and meets their needs.”

Six months after the HOPE app pilot program, 56% of the cohort are still in care. This retention rate is “very high in a relative sense,” Hodges said, because patients with opioid use disorder are at high risk for myriad access barriers and disengagement, making it difficult for addiction care professionals to obtain treatment plan retention reliable benchmark.

Hodges said the app illustrates a broader trend in addiction treatment: decentralized care.

She noted that “meet people where they are” initiatives for addiction care are taking off in urban areas, where support for those battling addiction is common. Yet while the opioid crisis has led to a dramatic increase in overdose deaths in both regions in recent years, rural communities have not seen the same type of treatment program mobilized on the streets. When it comes to how technology can better help rural patients with opioid use disorder, addiction care professionals “certainly have some room to learn,” she said.

As overdose deaths continue to rise in urban and rural communities, hospitals across the country are piloting ways to engage patients through technology. Marian Cullens, a nurse practitioner and director of the Center for Addiction Medicine at the University of Maryland Medical Center agrees that apps and other digital health products can help people with opioid use disorder better adhere to their treatment plans, noting that they can serve as “tools” A tool in a box” rather than a complete replacement for traditional care.

After attending the 2018 Addiction Care Nurses Conference, Currens began efforts to integrate pear therapy into her center’s treatment program. These apps, called reSET and reSET-O, allow users to complete modules to better understand their cravings and triggers, as well as modules on how to develop coping skills to avoid substance use. The apps also encourage participation by offering users the opportunity to earn rewards, such as coupons from Starbucks or Amazon.

The apps have been used by patients treated at the center more than a year, and Currens said many of her patients who choose to use the app find it a convenient way to stay connected to their recovery. Keeping patients engaged is a critical part of maintaining an addiction treatment program, she claims.

Both Currens and Hodges said the stigma of substance use has hindered addiction care from developing digital programs at the rate of other chronic diseases, such as diabetes and heart disease. This stigma adds to the constraints on how addiction specialists can provide care, but the persistent barriers that opioid use disorder patients face when seeking care make them one of the patient groups that will most benefit from digital innovations.

In an earlier interview with MedCity News, Zack Gray, CEO of digital health startup Ophelia, said: agree with this emotion. His company aims to help the “invisible 80 percent” of opioid users in the United States, who are not connected to the health care system, connect them with prescribing physicians to obtain drugs to control their addictions.

Ophelia provides medication-assisted treatment for opioid use disorder, which is considered the most effective treatment by the CDC and others. Gray called for widespread reimbursement of medication-assisted treatment for telehealth services after the pandemic emergency was officially declared over, arguing that the service could save lives.

Needless to say, digital health products such as medication-assisted treatment via telehealth and opioid use disorder treatment apps are not a panacea for the problem. to the opioid crisis. However, they are a step in the right direction, as they create greater flexibility and accessibility for patient populations who face significant barriers to participation and retention in treatment plans.

“We can’t treat addiction with brick-and-mortar stores forever,” Currens said. “We have to meet patients where they are, and digital technology is just one tool that can help make that happen.”

Photo: Sorbet, Getty Images



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