Advancing Health Equity: Evidence That a Prescription Digital Therapeutic for Opioid Use Disorder Enables Healthcare Access Across Geographic Regions

Abstract: Objectives: Between 80% and 90% of patients with opioid use disorder (OUD) do not receive behavioral treatments due, in part, to geographic barriers. This study evaluated associations between geographic regions in the United States and levels of engagement with the reSET-O prescription digital therapeutic (PDT) for patients with OUD using Rural-Urban Commuting Area (RUCA) classifications. Methods: De-identified data from patients with OUD who completed at least 1 lesson in a 12-week prescription for reSET-O were analyzed by the following RUCA categories: metropolitan, metro commuting (outside metropolitan), micropolitan (mid-sized cities), small town, and rural. Levels of engagement across RUCA categories were evaluated using: median days active in the PDT, median lessons completed, and percentage of patients retained during weeks 9-12 of treatment (defined as any activity in the therapeutic). Results: Evaluated were 5,263 patients with OUD: 2,904 from metropolitan areas; 709 in metro commuting areas; 1,081 in micropolitan areas: 300 in small towns; and 269 in rural areas. No meaningful differences were observed across metropolitan, metro commuting, micropolitan, small town, or rural RUCA categories in median active days (21, 23, 23, 23, and 22 respectively, Cohen’s d range 0-0.1) or median lessons completed (25, 28, 28, 27, and 27.5 respectively, Cohen’s d range 0.01-0.1). The percent of patients retained in weeks 9-12 of treatment (76%, 79%, 80%, 79%, and 79% respectively) demonstrated small effect sizes across most RUCA categories (Cohen’s h range 0.05-0.45). Conclusions: Patients with OUD across diverse population-based geographic regions engaged at similar levels with the reSET-O PDT.Short Description: This study evaluated associations between geographic regions in the United States and levels of engagement with a prescription digital therapeutic (PDT) among 5,263 patients with opioid use disorder (OUD). No significant differences were observed between diverse population-based geographic regions in median days active in the PDT, median lessons completed, or percent of patients retains in treatment, suggesting broad applicability of the PDT across regions.Name of Sponsoring Organization(s): Pear Therapeutics (US), Inc.