# Reward-based technology to improve opioid use disorder treatment initiation after an ED visit

> **NIH NIH R42** · Q2I, LLC · 2022 · $902,836

## Abstract

Project Summary/Abstract
Millions of people in the US misuse opioids each year, leading to thousands of deaths and costing billions of
dollars in total economic burden. Medication assisted treatment (MAT) for opioid use disorder (OUD) is highly
efficacious, but only a fraction of OUD persons access MAT, and treatment non-adherence is common and
associated with poor outcomes. This STTR Fast Track proposal is designed to increase rates of Suboxone
(buprenorphine/naloxone) treatment initiation and adherence among OUD patients recruited from emergency
and inpatient acute care. To accomplish these aims, the project will enhance the Opioid Addiction Recovery
Support (OARS), an existing Q2i company technology, with a new evidence-based reward, contingency
management (CM) function. CM interventions systematically reward (reinforce) specific behaviors like treatment
initiation and adherence with therapy attendance and drug-free urine tests, and are highly efficacious. An OARS
solution enhanced with a CM component (OARS+CM) that allows for the automatic calculation, delivery, and
redemption of rewards contingent on objective evidence of treatment behaviors may be key to improving
Suboxone initiation and adherence. In Phase 1 of this proposal, the existing OARS clinician portal and patient
mobile application will be modified to accommodate entry into the software system from an acute care setting
and to automatically manage and deliver rewards to create OARS+CM using patient-centered design principles.
Usability sessions with OUD patients and other key stakeholders will inform design. Primary usability outcomes
will be examined and the program iteratively updated. On meeting milestones, there will be proof-of-concept pilot
of usability, acceptability, and effects on initial behavior targets with approximately 20 patients and at least 4
providers. On meeting milestones, a RCT will follow, in which acute care OUD patients appropriate for outpatient
Suboxone (N = 150) are recruited and allocated to one of three study conditions: 1) treatment as usual (TAU),
comprised of screening, brief intervention, and referral to treatment by a trained clinician, 2) OARS, and 3)
OARS+CM. The active intervention window for the two intervention groups will be 12 weeks. Patients will be
onboarded prior to discharge from acute care. In the outpatient Suboxone setting, data on treatment adherence
and opioid use will be captured from clinical records for six months. Telephone follow-up assessments and vital
statics registry reviews will be at month 1, month 3 (end-of-study intervention period), and month 6. Primary
Suboxone treatment initiation outcomes will be scheduling and completing the Suboxone intake. Primary
Suboxone treatment outcomes will be sustained abstinence at Month 6 and longest duration of abstinence.
Analysis will examine data on cost avoidance and cost savings through reduced acute care visits between study
conditions.

## Key facts

- **NIH application ID:** 10414138
- **Project number:** 5R42DA049448-03
- **Recipient organization:** Q2I, LLC
- **Principal Investigator:** Edwin D Boudreaux
- **Activity code:** R42 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $902,836
- **Award type:** 5
- **Project period:** 2019-09-30 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10414138

## Citation

> US National Institutes of Health, RePORTER application 10414138, Reward-based technology to improve opioid use disorder treatment initiation after an ED visit (5R42DA049448-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10414138. Licensed CC0.

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