(PS1-A21) Patient Experience with and Perception of Remote Patient Monitoring in the Context of Medication Assisted Treatment for Opioid Use Disorder

The opioid epidemic serves as a leading public health threat in America. From spring of 2020 to 2021, there were over 100,000 deaths due to opiate use (SAMHSA, 2021). In 2021, 5.6 million Americans were found to have an opioid use disorder. Medication Assisted Treatment (MAT), including methadone and buprenorphine, is highly efficacious for opioid use disorder (OUD). Yet, high drop-out rates, particularly during the induction phase of treatment (initial weeks), limit the effectiveness of this approach (Klimas et al., 2021). It has been proposed that remote patient monitoring (RPM) with wrist-worn wearable devices may be useful for managing dose titration during induction onto MAT. It is unclear whether users will accept the use of this technology as a part of treatment.
 

To evaluate patient perception of RPM, 41 patients currently engaged in an opioid treatment program were recruited from a local treatment clinic. Of these patients, 18 recently completed a study at the clinic requiring them to wear an Empatica E4 wrist-worn device for 14 days for the purposes of RPM. Focus groups were conducted to interview patients on their opinions of or experiences with the device. Ten people did not attend the focus group session and were therefore excluded from the analysis. Of the remaining 31 participants, 13 were male (41.94%) and 18 were female (58.06%). All patients were currently receiving either methadone or buprenorphine maintenance as a part of their treatment. Focus groups were conducted in a semi-structured interview format using standardized questions. Content analysis was subsequently performed on transcribed data.
 

Emerging themes revolved around client motivation, privacy concerns, and data transparency. 96.77% of participants reported that they expected the device would be helpful for treatment and would be motivated to wear this device during treatment (M=0.97, SD=0.18). Only 19.35% of participants noted privacy or security concerns about the data (M= 0.19, SD= .40). Remarkably, 100% of respondents stated that they thought a doctor or counselor should have access to the data (M=1, SD= 1). 87.10% of participants reported that they would also want to have access to their data to monitor health (M=.87, SD= 0.34).
 

Participants commented on the advantages of RPM for enhancing accountability and requested features such as push notifications for real-time interventions (e.g. coping skills activities). Participants also noted that mutual access to objective data through RPM may be useful for fostering trust between patient and practitioners in the context of medication management. As a whole, focus group responses suggested that patients see value in the use of RPM for medication management in substance use treatment and are likely to comply with RPM using a wrist-worn device. Understanding the patient’s experience will be critical to the implementation of RPM strategies as the incorporation of novel sensor technologies into treatment approaches for substance use is likely to expand.