Text Messaging Buprenorphine (Suboxone) Programs Improve Communication with Clinicians

The use of cellular phones is reaching universality, as more than 9 out of 10 Americans own a mobile device.

 WHAT PROBLEM DOES THIS STUDY ADDRESS?

The widespread adoption of cell phones lends itself to the implementation of mobile phone interventions (i.e., mHealth) which are often cost-effective means of improving appointment and treatment adherence, reducing relapse, and strengthening communication between patient and provider.

Despite the potential of such interventions, most addiction treatment settings have yet to adopt these models.

HOW WAS THIS STUDY CONDUCTED?

The authors conducted a descriptive study in a safety net office-based buprenorphine-naloxone (Suboxone) program to assess mobile phone and text message use patterns among patients and to better understand preferences for improving communication with clinicians. The clinic, located in New York City, served uninsured patients and Medicaid beneficiaries with opioid use disorder.

All adult clinic attendees scheduled for an initial or follow-up visit between June and September 2013 were eligible for participation resulting in a sample of 71 participants completing a brief survey available for download here.

WHAT DID THIS STUDY FIND?

Demographic characteristics of the study respondents were similar to the overall population of the clinic, suggesting the sample was representative of patients treated at this clinic. Participants were 83% male, 42% African American, and 46 years old on average. About half had completed high school, one third was dependent on social services, and half lacked permanent housing.

93% reported owning a mobile phone though devices and phone numbers were transient with participants reporting owning 1.9 mobile phones and having 1.6 phone numbers on average over the past year. Mobile phone privacy was not a concern with only 16% reporting that their phone is accessed in a way that invaded privacy, but 40% were “very much” or “somewhat” concerned about text message privacy. All participants with cell phones reported using text messaging and a majority (79%) were comfortable with sending text messages.

Other features used on mobiles phones included: Internet (68%), smartphone applications (63%), e-mail (69%), and social media (68%).

This study supports the potential for implementing mHealth services for office-based buprenorphine-naloxone programs as a vast majority of clinic attendees have mobile phones with text messaging capabilities.

The study provides insights into both policy makers’ and providers’ perceptions of Suboxone. These insights may help inform efforts to enhance the dissemination of medication-assisted treatment through sufficiently addressing these concerns.

 WHY IS THIS STUDY IMPORTANT?

This study is an important first step in incorporating the needs and preferences of patients when determining best methods for developing future mHealth initiatives. It also helps demonstrate feasibility of mHealth interventions in office-based buprenorphine programs.

This survey is important for identifying important considerations such as  the transience of mobile phone numbers in this population. In order for the clinic to maintain contact with patients and retain them in care, it is important to update contact information frequently. This is particularly crucial given the nature of the clinic’s work (i.e., addiction and medication-assisted treatment services) since patients may need more frequent monitoring than in other healthcare fields.

mHealth interventions can traverse the digital divide, making them feasible even in low-income urban populations and settings.

LIMITATIONS

1. Given the small sample size, the authors were limited in their ability to conduct statistical analyses such as examining differences in mobile phone usage by demographic characteristics. These findings are representative of this specific clinic’s population but may not generalize to all patients using office-based buprenorphine services.

NEXT STEPS

This descriptive survey provided important information on mobile phone use patterns and preferences. Next steps include designing and testing mHealth interventions for this patient population. It is also necessary to assess attitudes and acceptability from the providers’ perspective before adopting mHealth interventions that allow clients to text message or call providers directly.

BOTTOM LINE

CITATIONS

Tofighi, B., Grossman, E., Buirkle, E., McNeely, J., Gourevitch, M., & Lee, J. D. (2015). Mobile phone use patterns and preferences in safety net office-based buprenorphine patients. J Addict Med, 9(3), 217-221. doi: 10.1097/adm.0000000000000121