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Text Message Reminders About Free Transportation for Outpatient Substance Use Disorder Treatment: A Pilot Randomized

Krisda H Chaiyachati1,2, Nandita Mitra3,4, David Grande5,3

  • 1Department of Medicine, The University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA. Krisda.chaiyachati@pennmedicine.upenn.edu.

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Summary

Weekly text reminders for transportation did not improve overall retention in substance use disorder treatment. However, a modest benefit was seen at 12 weeks for patients receiving medication for opioid use disorder.

Keywords:
appointment completionretention in caresocial determinants of healthsubstance use disordertransportation

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Area of Science:

  • Addiction Medicine
  • Public Health
  • Health Services Research

Background:

  • Substance use disorders (SUDs) present a significant public health challenge in the USA.
  • Transportation barriers limit patient access to outpatient SUD treatment, impacting retention.
  • Utilizing free transportation services is a potential strategy to improve treatment adherence.

Purpose of the Study:

  • To evaluate the effectiveness of weekly text message reminders for scheduling transportation.
  • To assess the impact of these reminders on retention in outpatient SUD treatment.
  • To explore differential effects based on medication for SUDs and SUD type.

Main Methods:

  • A pragmatic pilot study in Southwest Ohio (Nov 2020 - Jul 2022).
  • Participants with SUDs facing transportation barriers received free transport for 12 weeks.
  • Randomized 1:1 to receive weekly text reminders (intervention) or no reminders (control).

Main Results:

  • No statistically significant difference in 12-week retention between intervention (45.0%) and control (42.6%) groups.
  • No significant difference in 24-week retention between groups (intervention 25.7%, control 28.4%).
  • A trend towards greater 12-week retention in the intervention group for patients on SUD medications, but not significant at 24 weeks.

Conclusions:

  • Weekly text reminders for transportation scheduling did not significantly improve overall SUD treatment retention.
  • A potential benefit was observed at 12 weeks for patients receiving SUD medications, warranting further investigation.
  • No differences in retention were observed based on the type of SUD.