Removing implementation obstacles and tailoring reward-based technology programs to patient psychographic characteristics to sustainably increase adherence to substance use disorder pharmacotherapies

Project Summary The objectives of this proposal are to facilitate the implementation of loyalty reward based programs to increase adherence to medical treatment among patients with substance use disorders through innovative solutions to three challengesOne challenge is that increasingly complicated federal regulations dissuade many hospitals and clinics from implementing loyalty reward based programsSecondloyalty rewards programs using only monetary incentives can be financially unsustainableThirdthe effectiveness of reward programs may vary based on individual patient characteristicsWe propose to address these challenges byOffering health centers educational resources related to regulatory compliancea questionnaire to self assess complianceand an online forum to share experiencesDeveloping a reward library containing a taxonomy of typesschedulesand formats of monetary and non monetary rewards used in prior studies and the associated behavior changes they have producedSystematically review the research literature on the effectiveness of various forms of rewards for patients based on their demographic and psychographic traitsBuilding on our team s experience developing software to promote patient appointment attendancein Phase I a new tool will be created and tested with a sample of ten providers and ten patients who are prescribed but not fully adherent to substance use disorder treatmentThese participants will be recruited through our network of universitypharmacy and primary care partnersPatients will receive tailored text messagesin English or Spanishencouraging adherenceself report their treatment adherencewhich will be verified through smart pill caps and biological testingearn points for adherence that can be exchanged for rewards customized for them based on a baseline surveyand report their satisfaction with the program and process at the end of the four week studyThis pilot will assess the feasibility and perceived usefulness of the productIf the pilot is successfula Phase II study will be proposed to use an experimental medicine approach to evaluate the product s efficacy at increasing adherence to treatment and the mechanisms through which the rewards program works using a Multiphase Optimization Strategy and randomized controlled trial PROJECT NARRATIVE Contingency management incorporating loyalty rewards based systems can improve adherence to treatment among patients with substance use disordersHoweverchallenges to implementation include complex regulatory requirementsfinancial sustainabilityand varying effectiveness based on patient characteristicsThis proposed system for health centers will include educational materials about regulationsa taxonomy of monetary and non monetary reward typesand a mechanism for delivery of rewards and supportive messages that are personalized based on patient demographics and psychographics