Translating Research into Practice

The Responsibly Expanding Access to Life-Saving Methadone (REALM) study was a feasibility and usability assessment of Sonara, conducted in the spring of 2022 to help facilitate increased access to take-home methadone in response to SAMHSA’s relaxed take-home guidelines. REALM was administered in partnership with Baymark Health Services, and researchers at Oregon Health and Science University and Stanford University, with support from NIDA.

Four opioid treatment programs (OTPs) from across the county (2 in CA, 1 in NM, and 1 in MA) were invited to participate based on their ethnic and geographical diversity. Sonara coordinated with clinic directors to recruit 99 patients and 20 staff members across the sites for a series of quantitative and quantitative interviews on the usability of Sonara, its impact on patient’s lives in- and outside the clinic, and its effect on clinic operations.

Patients rated Sonara highly for usability while clinic staff found Sonara easy to integrate into their clinical processes. Patients in particular valued the increased access to take-home methadone, which in turn allowed them more time for employment, and social and family activities. They also liked the increased accountability that Sonara provided and rated their experience with Sonara more highly than their experience with unsupervised take-homes.

Clinic directors and staff recognized Sonara as an innovation that improved patients’ quality of life, equipped them with new tools that supported patients’ recoveries, and gave them a competitive advantage in the OTP marketplace.

Sonara continues to be actively used in all four OTPs that participated in REALM and is expanding to other sites in partnership with Baymark Health Services.

The Remotely Observed Methadone Evaluation (ROME) study was conducted in the fall of 2022, in partnership with the Oregon Health and Science University and Adapt Integrated Health Care. Funding is being provided via a grant from the NIH Helping to End Addiction Long-Term (HEAL) Initiative.

ROME Phase I successfully integrated a measurement-based care (MBC) tool into Sonara’s web-based app and demonstrated the feasibility of Sonara’s approach with both the patient-facing and clinician-facing web applications.

Phase II of the Remotely Observed Methadone Evaluation (ROME) study is currently underway, in partnership with Chestnut Health Systems and Family Guidance, Inc. This study was funded by a  $2.5 million Small Business Innovation Research (SBIR) grant awarded by NIDA. Phase I successfully integrated a measurement-based care (MBC) tool into Sonara’s web-based app and demonstrated the feasibility of the approach.

This study, which kicked off on Oct. 7, 2024, will use a randomized design to:

1. Assess Sonara’s impact on treatment retention and opioid use
2. Evaluate the effectiveness of the MBC tool
3. Test the influence of Sonara on patient, program, and payer costs, as well as health-related quality of life

The Remote Methadone Ingestion System Trial (RMIST) aims to evaluate the feasibility and efficacy of remote methadone ingestion monitoring that may mitigate patient safety risks of take-home methadone treatment regimens for opioid use disorder (OUD) while minimizing the risk of diversion.

Feasibility and efficacy will be assessed by measuring:

1. Patient adherence
2. Patient usability of the Sonara Virtual Dosing Window™.