Virtual reality at the point of care to increase uptake of moud in the ED

Ended Project Grant Awarded Last action

Award ID
R21HS029536
Recipient
Awarding agency
Obligated
$413,317

Award facts

Completion date
Funding agency
Center for Evidence and Practice Improvement Agency for Healthcare Research and Quality, Department of Health and Human Services
Place of performance
Springfield, MA 01199, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
Despite the widespread efforts to curb the opioid epidemic, the number of drug overdose deaths increased by nearly 30% from 2019 to 2020, of which approximately 75% involved an opioid. NIH and samhsa have directed significant funds towards improving access to increase the numbers of persons with opioid use disorder (OUD) receiving treatment. However, the treatment GAP continues to grow, with only a small minority of eligible patients taking opioid agonist therapy (OAT). Although curbing the epidemic will require efforts across multiple sectors, an immediate goal is to increase adoption of strategies already proven to be effective. Initiating buprenorphine in the emergency department (ED) is an important low threshold strategy to improve access, yet IT remains grossly underutilized. Interventions aimed at decreasing system and provider level barriers have not increased uptake. Therefore, increasing ED-initiated buprenorphine rates will likely not be realized unless patient level barriers (i.e., preferences) are explicitly addressed. The objective of this proposal is to develop and test a novel approach using virtual reality (VR) to increase uptake of buprenorphine in the ED. We hypothesize that participating in an immersive VR experience may be more effective than currently available counseling approaches and decision aids based on the superior ability of VR to activate emotional responses compared to other media or motivational approaches. Our intervention is based on the emotion- imbued choice model which describes the multiple effects of emotion on decision making and behavior. For example, positive affect enhances flexibility and willingness to examine alternative options, and activation of positive affect is a consistent finding of VR exposure in health-related applications. During the R21 phase we will employ a stakeholder-centered and user experience iterative design approach to develop and optimize an immersive VR experience designed to motivate patients with moderate to severe OUD to agree to treatment with buprenorphine while in the ED. During the R33 phase, we will conduct a parallel, 2-arm, randomized controlled feasibility trial. The data generated from the feasibility trial will determine the feasibility of performing a definitive full-scale randomized controlled trial (RCT) to ascertain whether VR- choice increases the rate of ED-initiated buprenorphine compared to TAU. Eligible participants will be randomized 1:1 to VR-choice or treatment as usual (TAU). We hypothesize that this feasibility RCT will meet prespecified process criteria justifying a full-scale RCT. The five process indicators are average number of eligible patients randomized per month, baseline measure completion, proportion randomized to the VR-choice arm completing the VR program, proportion in VR-choice arm developing VR-related symptoms, and acceptability of VR-choice. Each of these process indicators will be evaluated by preset "stop" and "go" thresholds. We will conclude that a full-scale RCT is not feasible if one or more process criteria meet the stop threshold.

Transactions

Action Obligated Date
Amendment $127,463
Amendment $0
Amendment $0
Amendment $142,927
Original award $142,927

Subawards

Subrecipient Amount Awarded
Berkshire Healthcare Systems, Inc. Berkshire Medical Center Scope of Work The Berkshire Medical Center (BMC) will serve as one of the 2 sites participating in this project. This trial will… $59,553

Quick answers

Who received award R21HS029536?

R21HS029536 was awarded to Baystate Medical Center, Inc. by Division of Grants Management (Agency for Healthcare Research and Quality) on September 30, 2023.

How much is award R21HS029536 worth?

$413,317 has been obligated on R21HS029536.

Which agency awarded R21HS029536?

Division of Grants Management (Agency for Healthcare Research and Quality) awarded R21HS029536, with funding from Center for Evidence and Practice Improvement (Agency for Healthcare Research and Quality).

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