A new automated text messaging service may curb opioid abuse and reduce the likelihood of relapse while also decreasing treatment costs, according to a study published in NEJM Catalyst.
The service provides automated text messages and phone calls to patients being treated for opioid addiction. Such messages ask patients if they’re feeling OK or struggling with potential relapse. Patients also can activate a panic button for immediate help.
Time saved from monitoring patients through individual phone calls and in-person appointments may trim medical costs and permit healthcare workers to treat more patients without accruing heavier workloads.
“There is an urgent need to address the opioid crisis in powerful new ways,” said senior author Avik Som, MD, Washington University, St. Louis, Missouri. “With the opioid epidemic, time is of the essence because of how quickly it’s grown and the lives that are lost.”
The mobile technology is designed to supplement cognitive behavioural therapy, support services, and other treatments aimed at combating opioid addiction.
“This is not meant to replace important programs or face-to-face contact between patients and providers,” said Dr. Som. “Rather, it is an additional tool that is affordable and immediate. It doesn’t require costly, time-consuming measures such as opening substance-abuse centres or training and hiring new staff.
The 21 patients in the study began using the texting service in late 2016 as part of their treatment at Preferred Family Healthcare, a community-based organization in St. Louis that offers treatment for substance abuse.
Data collected via the text messaging service found that at the time of enrolment, 9 patients (43%) reported substance abuse use in the previous 3 days, and 9 patients (43%) reported no use, while the remaining did not respond.
After 3 months, half of the 21 total patients reported no substance use, while the number of patients using was reduced to 2. The researchers can’t attribute the positive trend solely to the app but said the data are encouraging.
“Opioid users face strong urges to relapse because of the addictive power of the drug,” said Dr. Som. “As a result, healthcare workers struggle to keep patients engaged.”
Patients and caregivers reported that they preferred the ease and familiarity of text message communication.
“Texting is convenient, immediate, and nonjudgmental,” said Dr. Som. “It has become an integral part of how we communicate in society. Patients reported feeling more connected to healthcare providers.”
The service includes a “panic button” for patients facing relapse or other health struggles. Once the button is activated, healthcare workers phone patients and provide counselling, scheduling for in-person appointments, or other resources.
In addition, texts allow caregivers to monitor patients daily with automated questions such as “Have you used in the last day?” and “Have you had urges to use?” Patients who reported struggling received automated follow-up questions that classified their risk for relapse as high, moderate or low. At the same time, healthcare workers were alerted to intervene immediately.
“Healthcare providers can be proactive,” said Dr. Som. “It is so much more powerful to curb the temptation and break the cycle in advance of relapse rather than providing treatment only after the event has occurred.”
Further studies will allow researchers to examine the text-messaging strategy in a larger patient group and better gauge potential savings.