Program Reviews

MySafeRx

Program Overview

MySafeRx uses a mobile application (app) and electronic pill dispensers to deliver motivational coaching and medication adherence monitoring through text messaging and video conferencing.

MySafeRX delivers motivational interviewing and an adherence monitoring intervention to people with opioid use disorder receiving office-delivered buprenorphine treatment. The app includes functions for scheduling, video conferencing, text messaging, and transmitting access codes for the pill dispenser that manages buprenorphine access. Patients complete daily video calls with Mobile Recovery Coaches (MRCs) who address concerns, deliver the motivational intervention, provide daily access codes for the pill dispenser, and supervise user-administration of buprenorphine. Patients use the MySafeRx app to receive reminders for treatment adherence (e.g. weekly urine tests), message MRCs, schedule daily calls, and view pill dispenser access codes. MRCs use the MySafeRx app to message users, initiate video conference calls, release access codes, record daily adherence and substance use reports, and communicate with clinicians. MRC daily reports are color-coded by patient risk level (no concern, moderate concern, severe concern). Clinicians for each patient (e.g., prescriber, nurse, counselor) can view MRC daily reports and alerts from MRCs concerning their patients using a MySafeRx web interface.

Delivery:
Mobile app
Clinician-assisted
Electronic pill dispenser

Theoretical Approach:
Motivational Interviewing

Target Substance:
Opioids

Target Outcome:
Medication adherence

Ages:
Young Adults (18-30)
Adults (30+)

Genders:
Male
Female

Races/Ethnicities:
Unspecified

Setting:
Remote Access

Geographic Location:
Unspecified

Country:
USA

Language:
English

Evaluations

  • Schuman-Olivier Z, Borodovsky JT, Steinkamp J, et al. Addiction Science and Clinical Practice. 2018. 13(21). doi: 10.1186/s13722-018-0122-4

    Summary: Researchers conducted a pilot of MySafeRx with 12 adults (ages 18-39) with opioid use disorder who were receiving office-based buprenorphine therapy and were identified as high-risk for relapse. After an initial intervention training session, participants received MySafeRx for 4 weeks. Participant urine toxicology screens, completed at least weekly, were tracked during the intervention and for a 4-week follow-up period. Researchers evaluated feasibility (frequency of MRC observed patient-administration of buprenorphine, weekly participant reports of medication adherence), usability (staff-observed participant competence post-training, participant-reported intervention usability post-intervention), and acceptability (weekly participant reports of intervention acceptance, participant-reported intervention satisfaction post-intervention) of MySafeRx. Researchers compared feasibility, usability, and acceptability data to research benchmarks. Researchers analyzed preliminary evidence for intervention effects on illicit opioid abstinence using urine toxicology screens. Most participants (8/12, 67%) achieved more than 5 days/week of MRC-observed medication adherence (feasibility benchmark: 67% achieving >5 days/week of medication adherence). Ten participants reported 100% medication adherence, but MRCs observed only 1 participant who achieved perfect adherence. All participants achieved 90% competency during the initial training session (usability benchmark: 67% achieving 90% competency). Participants rated the usability of MySafeRx 78.8/100 on average (usability benchmark: average score >68/100). Participants reported high intervention acceptability (6.5/7; acceptability benchmark: average score >3/5) and intervention satisfaction (4.3/7; acceptability benchmark: average score >4/7). Abstinence from illicit opioids increased from 41.7% of participants at week 1 to 63.6% by week 4, but decreased to 36.4% by the end of the follow-up period.

    Take Away: MySafeRx was usable, feasible, and acceptable to at-risk adults with opioid use disorder receiving office-based buprenorphine treatment, but increases in abstinence from illicit opioids observed during the intervention period were not maintained at 4-week follow-up.