Symposia
Technology
Kirsten Langdon, Ph.D. (she/her/hers)
Warren Alpert medical School of Brown University
Providence, Rhode Island
ENhancing Distress Tolerance to Uplift Motivation in REcovery (iENDURE) is a two-part program designed to enhance motivation and improve tolerance of distress to promote buprenorphine uptake and recovery from Opioid Use Disorder. An initial pilot phase, in which the intervention was developed, refined, and tested among 10 participants (80% Male; Mage = 40.2, SD = 13.5) engaged in outpatient buprenorphine treatment was conducted to determine feasibility, acceptability, and preliminary clinical outcomes. iENDURE focused on enhancing motivational processes in combination with teaching strategies for tolerating distress through a single, brief, web-based session followed by eight weeks of personalized text messages. Daily messages served to remind participants of salient motivational factors for recovery as well as provide suggestions for distress tolerance coping skills that were tailored to mood state and level of urges/cravings. The mean daily response rate to text messages was 66.6%. Additionally, 100% of participants remained active in the text message intervention throughout the 8-week period, demonstrating high engagement. The mean score on the Client Satisfaction Questionnaire was 28.6 following the web-portion of the intervention and 27 at the end of the text message program, indicating a high degree of satisfaction. The average rating on the System Usability Scale at the end of the 8-week program was 65.3%, suggesting that the intervention was relatively easy to use. 100% of participants indicated that they would recommend iENDURE to a friend. At the end of the intervention, 87.5% of patients endorsed adherence to buprenorphine and abstinence from opioids (self-reported by the Timeline Follow-Back and confirmed via medical records). Mean level of opioid craving also decreased from baseline to the 8-week follow-up (Mbaseline = 5.33; M8-Week = 4.33). Our preliminary data suggests that when combined with treatment as usual, adjunctive motivational enhancement and distress tolerance skills training, delivered via a digital health platform, may hold promise for promoting engagement in and adherence to buprenorphine treatment. While results are promising, larger randomized trials are needed to determine the efficacy of iENDURE in comparison to a control condition.