Adherence to buprenorphine-XR through hybrid telehealth contingency management procedures: a case series

ABSTRACT

Background and objectives

Contingency management (CM) for substance use disorders (SUD) is effective in strengthening recovery behaviors, however can be quite burdensome. When health facilities experience staff shortages, adapting current CM protocols to be less staff and time intensive may be one way to address this challenge.

Methods

Case series (N = 3).

Results

Three veterans with opioid use disorder (OUD) received CM for treatment adherence through a Veteran Health Administration Outpatient Substance Disorder program. Due to the COVID-19 pandemic, traditional CM procedures resulted in limited accessibility and staff, delayed appointments, and decreased patient satisfaction. In response, the hybrid telehealth contingency management (HTCM) procedure was developed and implemented. Flexibility offered by HTCM allowed for consecutive completion of appointments and maintained adherence to BUP-XR treatment.

Conclusions

This is a novel method of CM implementation. HTCM streamlined the process and was successful in increasing accessibility, reducing time-burden on patients and staff, while preserving fidelity to key components of the model. Considerations for future implementation and implications of HTCM are discussed.

KEYWORDS:

• Opioid use disorder
• contingency management
• treatment adherence

Acknowledgments

The authors would like to thank James R. McKay, Ph. D for his expertise and assistance in revising the manuscript.

Disclosure statement

The contents do not necessarily represent the views of the U.S. Department of Veterans Affairs or the United States Government.

No potential conflict of interest was reported by the author(s).

Ethics approval

The current project was reviewed by the local Institutional Review Board and received exempt status. This study was an analysis of preexisting data and did not use human subjects.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14659891.2024.2351019

Additional information

Funding

This project did not receive any specific grant from funding agencies in the public, commercial, or non-for-profit sectors. The efforts described were supported by the Department of Veterans Affairs.