Bup-MBC for Opioid Use Disorder

(Bup-MBC Trial)

This trial tests a new strategy called Bup-MBC to manage opioid use disorder more effectively. It involves quick check-ins through texts or a patient portal to monitor changes in cravings and withdrawal between doctor visits. The system shares this information with the patient's doctor to catch issues early and provide timely support. This approach suits individuals currently receiving buprenorphine-naloxone (a medication for opioid use disorder) at a Vanderbilt University Medical Center clinic and who have an active patient portal account. The trial aims to determine if this method can be easily implemented in regular addiction clinics and if patients and doctors find it beneficial. As an unphased trial, it offers a unique opportunity to contribute to innovative strategies for managing opioid use disorder.

Research has shown that buprenorphine-naloxone (bup-nx) is generally safe and effective for treating opioid use disorder. The FDA has approved this medication to help manage opioid addiction by reducing cravings and withdrawal symptoms through its action on the brain.

While detailed information on Bup-MBC (the measurement-based care strategy) is limited, this approach involves using bup-nx along with regular check-ins to track patient progress. The goal is to identify any changes in cravings or withdrawal early, potentially leading to better treatment outcomes.

Researchers are excited about the Bup-MBC protocol for opioid use disorder because it integrates technology to enhance patient engagement and treatment outcomes. Unlike the usual care, which primarily involves standard buprenorphine-naloxone treatment, Bup-MBC includes automated patient-reported outcome measures (PROMs) via a patient portal or secure text, providing immediate, personalized feedback. This approach allows patients to request earlier contact with their clinician if needed, potentially addressing issues more proactively. Additionally, it offers clinician-facing summaries with non-directive prompts, aiming to improve communication and decision-making. These innovative features may lead to more responsive and personalized care for individuals struggling with opioid use disorder.

Research has shown that measurement-based care (MBC) can improve treatment outcomes for people with opioid use disorder. Studies have found that MBC methods, such as regular patient check-ins and feedback collection, help track symptoms and quickly adjust treatment plans. One review highlighted the effectiveness of patient-reported outcomes in monitoring progress in substance use treatment. Additionally, incorporating technology in MBC practices has been linked to symptom improvements. In this trial, participants in the Bup-MBC arm will receive automated between-visit PROMs and tailored feedback, suggesting that Bup-MBC could effectively manage opioid use disorder by providing timely support and care adjustments.⁶⁷⁸⁹¹⁰