Using a virtual conversational helper to keep people on buprenorphine engaged in care

Sustaining Recovery for People on Opioid Agonist Treatment With Conversational Agents

This study will try a smartphone-based animated virtual assistant to help people on buprenorphine for opioid use disorder stay in treatment.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 100 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Boston Medical Center (other)
• Locations: 1 site (Boston, Massachusetts)
• Trial ID: NCT06732596 on ClinicalTrials.gov

What this trial studies

This randomized trial will enroll 100 people starting buprenorphine at the Office-Based Addiction Treatment clinic at Boston Medical Center and randomly assign them to a smartphone-delivered embodied conversational agent (ECA) plus technical support, text reminders, and monetary incentives or to usual care without the app. The ECA is an animated virtual agent designed to simulate face-to-face conversations and provide recovery support. Participants complete an in-person baseline visit and telephone follow-ups at 6 and 12 months, with brief contact at 3 and 9 months to confirm contact information. The primary outcome is retention in buprenorphine treatment over 12 months as measured in the electronic health record.

Who should consider this trial

Good fit: Ideal candidates are English-speaking adults with opioid use disorder who are within 30 days of intake at the BMC OBAT clinic, currently prescribed buprenorphine, own a compatible smartphone, and are willing to share EHR data and alternate contacts.

Not a fit: People who expect to be incarcerated within 12 months, cannot use a smartphone due to severe sensory or motor impairments, fail the consent comprehension checks, or do not speak/read English are unlikely to benefit from this intervention.

Why it matters

Potential benefit: If successful, the intervention could help more patients stay on buprenorphine longer, which may reduce relapse and overdose risk.

How similar studies have performed: Embodied conversational agents have shown promise in supporting self-management and adherence in other healthcare areas, but their use specifically to improve buprenorphine retention is relatively novel.

Eligibility criteria

Inclusion Criteria:

* Diagnosis of Opioid Use Disorder (OUD)
* Within 30 days of intake at recruitment site (BMC OBAT)
* Possession of a smartphone that has minimum requirements
* English-speaking and reading
* Willing to release electronic health record (EHR) data
* Able to provide at least two alternate contacts who usually know how to get in touch with them
* Currently prescribed buprenorphine from an outpatient clinic

Exclusion Criteria:

* Incarceration anticipated within 12 months of enrollment
* Inability to comprehend the study protocol, defined as failing three times to answer correctly a set of questions during the consent process
* Inability to use the ECA app (i.e., due to markedly limited visual or auditory acuity or motor function required to interact with the ECA)

Where this trial is running

Boston, Massachusetts

• Office-Based Addiction Treatment (OBAT) Clinic, BMC — Boston, Massachusetts, United States (RECRUITING)

Study contacts

• Principal investigator: Karsten Lunze, MD MPH DrPH — Boston Medical Center
• Study coordinator: Karsten Lunze, MD MPH DrPH

Conditions: Opioid Use Disorder, Embodied conversational agent, Buprenorphine treatment, Medication for opioid use disorder, Office Based Addiction Treatment, Supportive Application for Recovery Assistance, Smartphone delivered intervention