Using digitally delivered measurement-based care in substance use disorder treatment: qualitative analysis of...

Background: Measurement-based care (MBC) is a clinical practice where patients complete standardized outcome measures throughout treatment to monitor clinical progress and inform clinical decision-making. However, MBC is rarely adopted in routine substance use disorder (SUD) treatment. We developed a digital MBC system and pilot tested it in an outpatient adult community SUD treatment setting.Objectives: The current study aims to characterize qualitative feedback from the pilot participants about their experiences using the MBC system in SUD treatment, focusing on perceived benefits, drawbacks, and suggestions for improvement.Methods: Participants (N = 30; n = 11 female 37%) completed weekly MBC questionnaires via smartphone for 6 months and completed structured interviews at 6-, 12-, and 24-weeks. Themes were identified using a combination of inductive/deductive thematic analysis.Results: Participants highlighted several benefits of using the digital MBC system, including improved self-reflection (e.g. goal clarification, noticing changes over time), treatment enhancement (e.g. improving patient-clinician communication, extending the reach of treatment beyond scheduled sessions), and ease-of-use (e.g. brief, understandable questions). Drawbacks were less frequently expressed and included limited integration with clinical care, repetitiveness of questionnaires, and some questions being difficult to answer. Suggestions included making elements more personalized and improving interactivity with the digital interface.Conclusion: Patients report several benefits of integrating digitally delivered MBC into SUD treatment, along with recommendations that may improve its usability and usefulness. Integrating MBC technology into SUD treatment may potentially aid patients by enhancing self-reflection, facilitating more efficient communication with clinicians, and extending the reach of treatment beyond scheduled treatment sessions.