Implementation of a Mobile Digital Tool Supporting Medication for Opioid Use Disorder Treatment Improves Retention - Stepped-Wedge Cluster Randomized Controlled Trial

Q: What problem does the study address about medication for opioid use disorder?

MOUD retention is low despite proven efficacy. Structural, systemic, and individual factors contribute to high discontinuation rates.

Q: What is Recovery Connect and how is it used in the trial?

Recovery Connect is a white-labeled remote patient monitoring app used within a blended treatment model. It provides real-time monitoring, psychoeducational/skill content, and messaging between patients and clinicians.

Q: How did app implementation affect patient retention and adherence?

Clinics implementing the app showed higher 30-day retention than clinics not using it. Early linkage and engagement predicted better treatment continuance and more daily doses in the first 7 and 30 days.

Sep 29, 2026

Uploaded by Fahsai

Digital support is needed because retention in medication for opioid use disorder (MOUD) remains low due to structural, systemic, and individual barriers that drive discontinuation. This stepped-wedge cluster randomized trial evaluates Recovery Connect, a white-labeled remote patient monitoring app, within a blended care model across 9 outpatient clinics. The study measures 30-day retention, treatment continuance, and medication adherence outcomes linked to app implementation, linkage, and engagement.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Background

Objective

Methods

Results

Conclusions

Keywords

JOURNAL OF MEDICAL INTERNET RESEARCH Palacios et al Original Paper Implementation of a Mobile Digital Tool Supporting Medication for Opioid Use Disorder Treatment Improves Retention: Stepped-Wedge Cluster Randomized Controlled Trial | Jorge E Palacios 1, MD, PhD; Robert Sherrick2, MD; Tim Janssen3, PhD; Elana Deuble2, LMSW; Sara Lorenzen 1, MS; Mark Schaefer2, MA; Jenna Tregarthen 1, MA | | --- | | 1Bright Therapeutics, San Francisco, CA, United States 2Community Medical Services, Scottsdale, AZ, United States
3Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
Corresponding Author:
Jorge E Palacios, MD, PhD Bright Therapeutics
166 Geary Street STE 1500 \#2552 San Francisco, CA, 94108 United States
Phone: 1 7906588966
Email: [jorge.palacios@brighttherapeutics.com](jorge.palacios@brighttherapeutics.com)
Abstract | Background: Despite its proven efficacy, retention in medication for opioid use disorder (MOUD) remains low, with structural and systemic barriers—such as access to care and treatment setting—alongside individual factors, including personalization and motivation, contributing to high rates of discontinuation. Digital interventions offer a promising approach to address many of these barriers; however, robust evidence for their effectiveness in improving retention and engagement with treatment remains scarce. Objective: This study aims to evaluate the impact ofRecovery Connect—a white-labeled version ofRecovery Path and a digital remote patient monitoring app used as part ofa blended treatment model for opioid use disorder—on patient retention, treatment continuance, and medication adherence. Methods: A stepped-wedge cluster randomized trial was conducted across 9 outpatient MOUD clinics, organized into 8 clusters. Clusters were sequentially transitioned from usual care to a digitally enhanced model incorporating Recovery Connect, which provided real-time monitoring, psychoeducational and skill-based content, and messaging between patients and clinicians. The primary outcome was 30-day retention in treatment following exposure (implementation of the app in the clinic), linkage (downloading and connecting to the app), or engagement (levels of app usage) . Secondary outcomes included treatment continuance—defined as receiving at least 75% of expected doses—and the number of daily doses taken within the first 3, 7, and 30 days after admission. Cluster-controlled discrete-time survival analyses were conducted, adjusting for patient-and clinic-level covariates. Results: Patients admitted to clinics that had implemented the app (n=1205) showed increased retention (922/1205, 75.5%) compared with those in clinics that had not (203/319, 63.6%, P<.001) . Patients who downloaded and linked with a mental health professional on Recovery Connect had an 81.3% likelihood of retention, compared with 72.0%(P<.001) among those not linked. Linkage also significantly predicted higher treatment continuance and a greater number of daily doses taken during the first 7 and 30 days (P<.001) . Low, moderate, and high engagement levels were associated with progressively higher 30-day retention compared with no engagement (P<.001) . Conclusions: This study provides evidence that implementing Recovery Connect (Recovery Path) significantly enhances patient retention and treatment continuity in outpatient opioid use disorder care. Early linkage and engagement during the first week were strong predictors of positive outcomes, underscoring the value of early, proactive digital support. These findings reinforce the effectiveness of blended digital-clinical models, aligning with broader evidence that integrating remote monitoring enhances continuity ofcare and supports recovery. Policy implications include the need for reimbursement mechanisms, workflow integration, and ethical, privacy-preserving implementation to enable scalable and equitable adoption

FAQs

What problem does the study address about medication for opioid use disorder?

MOUD retention is low despite proven efficacy. Structural, systemic, and individual factors contribute to high discontinuation rates.

What is Recovery Connect and how is it used in the trial?

Recovery Connect is a white-labeled remote patient monitoring app used within a blended treatment model. It provides real-time monitoring, psychoeducational/skill content, and messaging between patients and clinicians.

How did app implementation affect patient retention and adherence?

Clinics implementing the app showed higher 30-day retention than clinics not using it. Early linkage and engagement predicted better treatment continuance and more daily doses in the first 7 and 30 days.

Sep 29, 2026

Uploaded by Fahsai