Prescription Digital Therapeutics for Substance Use Disorder in Primary Care: Mixed Methods Evaluation of a Pilot Implementation Study Article Swipe
Jessica Mogk
,
Abisola Idu
,
Jennifer F. Bobb
,
Dustin Key
,
Edwin S. Wong
,
Lorella Palazzo
,
Kelsey Stefanik-Guizlo
,
Deborah A. King
,
Tara Beatty
,
Caitlin N. Dorsey
,
Ryan M. Caldeiro
,
Angela Garza McWethy
,
Joseph E. Glass
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.2196/59088
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.2196/59088
Background Delivering prescription digital therapeutics (ie, evidence-based interventions designed to treat, manage, or prevent disorders via websites or smartphone apps) in primary care could increase patient access to substance use disorder (SUD) treatments. However, the optimal approach to implementing prescription digital therapeutics in primary care remains unknown. Objective This pilot study is a precursor to a larger trial designed to test whether implementation strategies (practice facilitation [PF] and health coaching [HC]) improve the delivery of prescription digital therapeutics for SUDs in primary care. This mixed methods study describes outcomes among patients in the 2 pilot clinics and presents qualitative findings on implementation. Methods From February 10 to August 6, 2021, a total of 3 mental health specialists embedded in 2 primary care practices of the same integrated health system were tasked with offering app-based prescription digital therapeutics to patients with SUD. In the first half of the pilot, implementation activities included training and supportive tools. PF (at 1 clinic) and HC (at 2 clinics) were added in the second half. All study analyses relied on secondary data, including electronic health records and digital therapeutic vendor data. Primary outcomes were the proportion of patients reached by the prescription digital therapeutics and fidelity related to ideal use. We used qualitative methods to assess the adherence to planned activities and the barriers and facilitators to implementing prescription digital therapeutics. Results Of all 18 patients prescribed the apps, 10 (56%) downloaded the app and activated their prescription, and 8 (44%) completed at least 1 module of content. Patients who activated the app completed 1 module per week on average. Ideal use (fidelity) was defined as completing 4 modules per week and having a monthly SUD-related visit; 1 (6%) patient met these criteria for 10 weeks (of the 12-week prescription period). A total of 5 (28%) patients had prescriptions while HC was available, 2 (11%) were successfully contacted, and both declined coaching. Clinicians reported competing clinical priorities, technical challenges, and logistically complex workflows in part because the apps required a prescription. Some pilot activities were impacted by staff turnover that coincided with the COVID-19 pandemic. The facilitators to implementation were high engagement and the perception that the apps could meet patient needs. Conclusions The pilot study encountered the barriers to implementing prescription digital therapeutics in a real-world primary care setting, especially staffing shortages, turnover, and competing priorities for clinic teams. The larger randomized trial will clarify the extent to which PF and HC improve the implementation of digital therapeutics. Trial Registration ClinicalTrials.gov NCT04907045; https://clinicaltrials.gov/study/NCT04907045
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.2196/59088
- OA Status
- gold
- Cited By
- 4
- References
- 64
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4402131431
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4402131431Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.2196/59088Digital Object Identifier
- Title
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Prescription Digital Therapeutics for Substance Use Disorder in Primary Care: Mixed Methods Evaluation of a Pilot Implementation StudyWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-09-02Full publication date if available
- Authors
-
Jessica Mogk, Abisola Idu, Jennifer F. Bobb, Dustin Key, Edwin S. Wong, Lorella Palazzo, Kelsey Stefanik-Guizlo, Deborah A. King, Tara Beatty, Caitlin N. Dorsey, Ryan M. Caldeiro, Angela Garza McWethy, Joseph E. GlassList of authors in order
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https://doi.org/10.2196/59088Publisher landing page
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
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https://doi.org/10.2196/59088Direct OA link when available
- Concepts
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Medical prescription, Medicine, Psychological intervention, Electronic prescribing, Coaching, Digital health, Family medicine, Health care, Nursing, Psychology, Economic growth, Psychotherapist, EconomicsTop concepts (fields/topics) attached by OpenAlex
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4Total citation count in OpenAlex
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2025: 3, 2024: 1Per-year citation counts (last 5 years)
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64Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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