Text messaging tool reduces opioid misuse, cuts costs in small study
An automated text messaging service could help fight the opioid epidemic by reducing relapse rates while decreasing the cost of treatment, according to a study published April 17 in NEJM Catalyst.
Researches at Washington University School of Medicine and Epharmix, a St. Louis-based digital health company, conducted the study to test the impact and feasibility of the text messaging service.
"There is an urgent need to address the opioid crisis in powerful new ways," said the study's senior author, Avik Som, an MD/PhD student at Washington University. "With the opioid epidemic, time is of the essence because of how quickly it's grown and the lives that are lost.”
The text service sends messages and phone calls to patients struggling with opioid addiction. The messages ask patients how they are feeling, if they’re struggling with a potential relapse and includes a panic button for immediate help. If a patient were to report struggling with a potential relapse, the platform sends follow-up questions to classify their risk of relapse and notify healthcare providers to intervene. The text messages act as a support tool to cognitive behavioral therapy and other treatments in reducing the opioid epidemic.
"This is not meant to replace important programs or face-to-face contact between patients and providers," Som said. "Rather, it is an additional tool that is affordable and immediate. It doesn't require costly, time-consuming measures such as opening substance-abuse centers, and training and hiring new staff.”
In this study, 21 patents were enrolled and received the texting service as a part of their treatment. Data collected through the service found nine patients (43 percent) reported substance abuse use in the previous three days, another nine reported no use and the remaining two did not respond. After three months of using the text service, half the patients reported no substance use. The patients who did report use decreased to 10 percent. The researchers were unable to attribute this trend solely to the app but said the data are encouraging.
Additionally, the text service cut per-patient costs for caregiver services specific to addiction-related care by 19 percent, from $926 annually to $753.
"Opioid users face strong urges to relapse because of the addictive power of the drug," Som said. "As a result, healthcare workers struggle to keep patients engaged. "Texting is convenient, immediate and nonjudgmental. It has become an integral part of how we communicate in society. Patients reported feeling more connected to healthcare providers."