Summit program to taper long-term opioid therapy in Veterans: A mixed-methods feasibility study.

Area of Science:

• Pain Management
• Digital Health
• Behavioral Therapy

Background:

• Long-term opioid therapy poses risks and often lacks benefits, necessitating supportive patient-centered tapers.
• Clinicians and patients face challenges during opioid tapering, including resource limitations and fear of increased pain.

Purpose of the Study:

• To evaluate the feasibility and acceptability of the Summit web-based app for supporting voluntary opioid tapers.
• To assess the potential for a full-scale trial of the Summit program through a nine-month randomized pilot feasibility trial.

Main Methods:

• A randomized pilot feasibility trial (NCT04746833) involving 44 patients over nine months.
• Participants were randomized to motivational interviewing plus the Summit app or a control pain monitoring app.
• Feasibility (enrollment, retention, program use) and acceptability (quantitative and qualitative) were primary outcomes.

Main Results:

• The study achieved a 4.9% enrollment rate, enrolling 44 patients.
• While Summit website utilization was low, study retention and intervention acceptability were high across both arms.
• Approximately one-third of participants reduced their opioid dosage, and qualitative feedback indicated positive shifts in pain perception.

Conclusions:

• The Summit app demonstrates high acceptability and retention, suggesting potential for supporting opioid tapering.
• Challenges in recruitment and program utilization necessitate modifications to the enrollment strategy for future large-scale trials.
• Despite low app usage, the pilot provides valuable insights into patient support during opioid dose reduction.