A-CHESS Bundling: New project combines medication and mobile health

Submitted by: 09/02/2015 by Maureen Fitzgerald

The Center for Health Enhancement Systems Studies (CHESS) has received a grant from the National Institute on Drug Abuse to test combining medication-assisted treatment (MAT) with the A-CHESS mobile health system.

“We know that effective treatment for opioid dependence requires medication, behavioral interventions, and screening for overdose protection, but few patients receive this combination of services,” says Dave Gustafson, Director of CHESS and principal investigator for the study. “We also know that many of the people who do receive MAT generally do not maintain long-term abstinence,” adds Gustafson.

Researchers from the University of Wisconsin Division of Infectious Diseases are partnering with the project. They will help design services for HIV and hepatitis C (HCV) prevention and care that will be integrated into the study.

“Our hope with this project is to improve patients’ long-term recovery from opioid dependence, reduce the risk of HCV and HIV infection, and understand how we can improve medication-assisted treatment and mobile health interventions,” says Gustafson.

The project will randomly assign 440 opioid users from three addiction treatment centers (Gosnold on Cape Cod, SSTAR in Massachusetts and Rhode Island,) and ARC Community Services of Madison, WI) to receive MAT and A-CHESS or MAT alone.

Patients will be followed for 24 months to assess the long-term impact of either intervention. The research team will compare illicit opioid use between patients in the two study groups. Differences between the two groups in terms of quality of life, retention in treatment, and unscheduled use of health services will be analyzed. For HCV and HIV, the research team will examine differences in the two groups in screening rates, risk behaviors, testing, and among those infected, treatment initiation. 

A-CHESS has been tested and proven effective in several pilot tests. In a randomized controlled study of 349 patients with alcohol use disorders, roughly half used the A-CHESS smartphone app in addition to treatment as usual. The study found that not only did the A-CHESS app users report fewer risky drinking days (days in which drinking exceeded four standard drinks for men and three for women in a two-hour period), but also that smartphone app users had a higher likelihood of consistent abstinence from alcohol. The success of this pilot test and others suggest that A-CHESS will also have positive effects on opioid users.

Kim Johnson, Deputy Director of NIATx and Co-Director of the ATTC Network Coordinating Office is also on the research team. “We are interested in better understanding whether men and women use mobile recovery technologies differently and whether the impact of mobile technologies differs for men and women.”

CHESS researchers Fiona McTavish and Dr. Amy Atwood are also part of the research team, along with UW-Madison scientists and researchers Dr. Tim Baker and Dr. Ryan Westergaard, School of Medicine and Public Health; Dr. Dhavan Shah and Rachel Kornfield of the School of Journalism and Mass Communication, and Dr. Oguzhan Alagoz of the College of Engineering.

The five-year project launched in August 2015. Recruitment of study participants will begin in February 2016.

For more information, contact Fiona McTavish: fiona.mctavish@wisc.edu

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