Technology-assisted buprenorphine treatment for rural patients with opioid use disorder (OUD)

Innovative approaches are needed to expand OUD treatment to rural areas. We previously demonstrated the initial efficacy of technology-assisted Interim Buprenorphine Treatment (IBT) for reducing illicit opioid use (Sigmon et al., NEJM, 2016). Dr. Sigmon will present outcomes from two RCTs that build upon those initial outcomes by evaluating IBT efficacy (a) over longer durations and (b) among patients residing in rural settings.

Participants visited the clinic bi-monthly to ingest their buprenorphine dose, provide an observed urine specimen, and receive remaining doses via computerized device. They completed daily Interactive Voice Response (IVR) monitoring calls and random call-backs. Control participants received treatment referrals, and all received HIV, HCV and overdose education, Narcan, and monthly assessments throughout both 6-month trials.

IBT participants achieved greater illicit opioid abstinence than controls (88%, 88%, 83%, 86%, 91%, 86% of urine specimens abstinent across the 6 monthly assessments vs. 0%, 13%, 30%, 30%, 29%, 29%; p’s<.001). Adherence to buprenorphine administration (98%), IVR calls (92%), and random callbacks (88%) is also high.

Technology-assisted buprenorphine holds significant promise for patients in isolated rural areas.