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BALTIMORE, MD (September 2020) -- emocha Health, in collaboration with the University of Washington, has been awarded an innovation grant from the National Institute on Drug Abuse (NIDA) to study emocha’s digital adherence program with patients taking methadone to treat opioid use disorder (OUD) during the COVID-19 pandemic. In April 2020, a King County-based opioid treatment program (OTP) rapidly implemented emocha’s video Directly Observed Therapy program to provide remote supervision and COVID-19 symptoms monitoring to patients with extended take-home doses of methadone. Evaluating how these patients used emocha’s asynchronous video platform to stay on track and report possible COVID-19 infection will help stakeholders better understand how this technology can be used to support patients with OUD through a public health crisis, and ways in which future OTPs might use asynchronous video DOT once the crisis has ended.

Methadone is a medication-assisted treatment that has been used for decades to manage and treat opioid addiction by reducing cravings and the effects of withdrawal, and blocking the effects of opioids. Methadone is dispensed by more than 1,250 OTPs across the country, which together serve over 350,000 people. OTPs are highly regulated and often require patients to visit the clinic every day to take their medication under in-person observation. Medication adherence through observation is crucial to the success of both methadone treatment and patient safety. If an individual misses a dose, they can experience withdrawal or cravings, are more likely to relapse, and could more easily overdose, either from methadone or an illicit drug. Supervision in the form of DOT prevents diversion, ensures that medication is taken as prescribed, and mitigates the risk of overdose. 

In early 2020, many health and human service agencies recommended changes to in-person care intended to reduce COVID-19 exposure. These changes curtailed traditionally in-person DOT services for patients prescribed methadone, which reduced a patient's individual access to care. Patients on methadone maintenance treatment were forced to decide whether to attend clinics and risk infection or infecting others, or miss their daily dose and risk their successful recovery. The Substance Abuse and Mental Health Services Administration issued guidance allowing OTPs to give stable patients a 28-day take-home supply of medication for opioid use disorder, and a 14-day supply for patients who are less stable if approved by an OTP during the COVID-19 pandemic. Such accommodations are crucial for safeguarding individuals prescribed methadone, but adherence remains critical to treatment success and patient safety. 

emocha’s platform scales the CDC-endorsed standard of DOT with video technology and human engagement, securing high rates of adherence comparable to in-person DOT. The emocha mobile app has been successfully utilized in tuberculosis control programs in over 300 local health departments around the world, where DOT remains an integral component of treatment support and adherence monitoring. Video DOT can increase treatment flexibility by overcoming logistical barriers and reducing perceived stigma. A previous pilot study conducted by the University of Washington indicated that 93% of participants were able to use the app and 71% reported being "very satisfied" with using the application to document their office-based buprenorphine treatment.

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About emocha Mobile Health

emocha empowers patients to take every dose of medication through video technology and scalable human engagement. Patients use a smartphone application to report side effects, communicate with providers, and video record themselves taking medication at every dose. Providers or emocha’s clinician-led Adherence Solutions team use a secure web portal to assess adherence and engage with patients. The platform is being used by public health departments, hospitals, health centers, and managed care organizations across the globe to radically improve medication adherence for patients with diabetes, tuberculosis, opioid use disorder, asthma, COPD, hepatitis C, and other chronic and infectious diseases. Learn more at www.emocha.com

‍Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number R41DA053081. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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