Feasibility, acceptability and preliminary efficacy of a cognitive behavior therapy text-message intervention among individuals with opioid use disorder in Kenya: a randomized feasibility trial

Abstract

BackgroundOpioid use disorder is associated with a huge burden of disease and treatment gap. Delivery of psychosocial treatment using digital platforms can bridge the treatment gap to improve treatment access among individuals with opioid use disorder. The aim of this study was to assess the acceptability, feasibility and preliminary efficacy of a text-message intervention in patients with opioid use disorder in Nairobi, Kenya.MethodsA feasibility pilot trial was conducted at a methadone clinic in Nairobi. A text-message intervention based on cognitive behaviour therapy was delivered for six weeks compared with a control group receiving standard treatment among 46 individuals on methadone treatment (30 in intervention and 16 in control group). Follow up was at six weeks and three months. Primary outcome was reduction in opioid use and retention in treatment. Implementation outcomes assessed were acceptability and feasibility of the intervention.ResultsThe participants comprised 89.1% male with a mean age of 32 years (SD 8.7). There was a reduction in opioid use among all the participants post-intervention with higher reduction in the intervention group compared the control group with prevalence of opioid use at 35.7% and 56.3%, respectively although there was no statistically significance difference. Retention in methadone was 93.3% at six weeks and 83.3% at 3 months follow up among participants in the intervention group. High acceptability and satisfaction were reported with the intervention based on quantitative assessment post-intervention.ConclusionResults from this pilot feasibility study suggest that a text message intervention is acceptable and scan be implemented in substance use disorder treatment with promising effect in improving outcomes. Further research using a larger sample size is recommended.Trial registrationPan African Clinical Trial Registry: Registration number: PACTR202201736072847. Date of registration: 10/01/2022.