Assessing the feasibility, usability and acceptability of the platform among individuals in outpatient buprenorphine treatment: Lessons learned from a pilot randomized controlled trial.

Background: Increasing buprenorphine/naloxone (B/N) access for opioid use disorder (OUD) is essential yet ensuring adherence and preventing diversion remains challenging. This study examines the feasibility, usability, and acceptability of , a mobile platform integrating motivational coaching, adherence monitoring, and electronic dispensing during office-based B/N treatment.

Methods: In this multi-site randomized controlled trial, provided coaching and supervised self-administration of B/N by mobile recovery coaches (MRCs) via videoconference. Referred adults (ages 18-65) with OUD were randomized to 1) 42-days of adjunctive treatment ( = 13) or 2) a standard care control group ( = 14).

Results: The randomized sample was 63% female and 100% White. Twelve of 13 participants completed at least one MRC session. The mean system usability score reported by participants was 78.4 ( = 12). Participants indicated they would recommend to a friend (mean= 4.1 of 5), and that the dispenser (4.1 of 5) and videoconferencing (4.2 of 5) were easy to use. The MRC component had the highest acceptability (4.4 of 5). MRCs observed B/N self-administration for an average of 64.3% of the required study days (men: 68.9%; women: 57.9%). On average, men ( = 4) met with MRCs on 32±14 days versus 47±6 days for women ( = 8). Exploratory analyses did not show significant differences between intervention and control groups.

Conclusions: Despite the small sample, this study supports usability and acceptability of . Increased adherence monitoring, even with remote coaching had limited appeal, which impacted feasibility due to slow recruitment, especially as community prescribing with relaxed monitoring requirements became more widespread.