Mobile telephone contingency management to encourage adherence to supervised medication among individuals receiving opioid agonist treatment: a feasibility study (TIES2)

2023-2024, NIHR, Research for Patient Benefit Programme, 1st Jan 2023 – 31st March 2024

Aim: This study aims to assess the feasibility of conducting a future confirmatory trial to assess the clinical and cost effectiveness of mobile telephone-delivered Contingency Management to encourage adherence with supervised methadone/ buprenorphine in community pharmacies. It builds on a previous feasibility study conducted by the team in 2017. This new study has been re-focused in-line with changes in policy and practice around supervision introduced since the COVID-19 pandemic.

Methods: The study uses a cluster randomised controlled design in which each cluster comprises an individual drug service and its allied community-pharmacies. (1 clinic + up to 7 pharmacies.)

Three participating clinics will be randomised to deliver either:

  • Supervised methadone/buprenorphine + text message incentives (mCM)
  • Supervised methadone/buprenorphine + text message reminders (mR); or
  • Supervised methadone/buprenorphine + no text message incentives or reminders (Treatment as Usual, TAU).

Within each cluster, participants will receive the same allocated condition thus minimising the risk of contamination between arms. At each cluster we will recruit clinically significant group of existing patients receiving supervised opioid agonist treatment who are most at risk of non-adherence (20 x 3 = 60). This includes patients who regularly miss doses and must re-present at the clinic for a dose assessment.

The study is designed to establish whether recruitment targets can be achieved, that study procedures are acceptable and outcome data can be collected. The study will confirm the primary and secondary outcome measures to be used in a future confirmatory trial and to inform sample size calculations.

Research team: Dr Nicola Metrebian, Ewan Carr, John Strang, Carol-Ann Getty (all Kings),

Tim Weaver (Middlesex), Jenny Scott (Bath), Mike Kelleher (SLaM) Steve Pilling (UCL)

Contact: Tim Weaver, t.weaver@mdx.ac.uk