# Digital treatments for opioids and other substance use disorders (DIGITS) in primary care: A hybrid type-III implementation trial

> **NIH NIH R01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2020 · $743,340

## Abstract

PROJECT SUMMARY
The proposed study addresses a critical knowledge gap: How to best implement digital treatments for
opioids and other substance use disorders (SUDs) in primary care (PC). In 2017, the US Food and Drug
Administration approved the first ever digital therapeutic for any medical condition. The therapeutic is reSET, a
smartphone-based version of the Therapeutic Educational System, which is a computerized cognitive-
behavioral treatment for SUDs. We will study implementation of reSET into PC to potentially improve care for
people with SUDs, and as a model for how to sustainably implement digital treatments into real-world
healthcare. Digital treatments could extend the reach of SUD therapy to more people and could address the
lack of access to psychosocial treatment, a significant barrier to buprenorphine prescribing (a life-saving
treatment for opioid use disorders [OUD]) in PC. A prior implementation trial found that a digital SUD treatment
in PC was not sustained in part because of workflow and cost burdens so our study design and analytic plan
focus on these issues. Our delivery system partners in Kaiser Permanente Washington are committed to
collaborating with us to study strategies for implementing reSET in 25 PC clinics in Washington State and to
address prior implementation challenges documented in the literature. After piloting in 2 clinics, we will
randomize 23 clinics in a 2x2 factorial design to four approaches: (1) “standard implementation,” which is an
evidence-based implementation strategy previously used by our delivery system partners; (2) “standard
implementation with external facilitation,” a clinician-facing implementation strategy; (3) “standard
implementation with patient coach,” a patient-facing implementation strategy using medical assistants to
support patient adoption and engagement; and (4) “standard implementation with both.” These implementation
strategies have some evidence in PC, but their impact on real-world implementation of a digital treatment has
not been evaluated. Specific Aims are to (1) Estimate the effect of clinician-facing (external facilitation) and
patient-facing (patient coach) implementation strategies in increasing the reach and fidelity of a digital SUD
treatment in PC clinics, and (2) compare the population-level cost-effectiveness of each implementation
strategy in increasing reach, fidelity, and abstinence by patients. IMPACT: Researchers and health systems do
not know how to reach large numbers of patients with OUDs and other SUDs. Digital treatments are
promising, but health systems lack evidence to guide implementation of digital therapies. This study will
estimate and compare the effectiveness of clinician-facing and patient-facing implementation strategies,
providing health system leaders with data on how to best implement digital treatments.

## Key facts

- **NIH application ID:** 9902391
- **Project number:** 5R01DA047954-02
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Joseph Edwin Glass
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $743,340
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9902391

## Citation

> US National Institutes of Health, RePORTER application 9902391, Digital treatments for opioids and other substance use disorders (DIGITS) in primary care: A hybrid type-III implementation trial (5R01DA047954-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9902391. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*