A "refill" of Pear Therapeutics’ reSET-O digital prescription therapeutic for treating opioid use disorder is associated with high levels of abstinence and treatment retention as well as fewer hospital encounters, according to a study published in Hospital Practice. 

Most of the study’s authors are current or former Pear employees. 

TOP-LINE DATA

Out of a group of 3,817 people who completed a 12-week prescription of reSET-O, 643 were prescribed a refill of another 12 weeks. 

For those who completed a total of 24 weeks of treatment, abstinence from opioids during the last four weeks was 86%. Those who didn’t input data were considered to be positive for opioids.

Researchers found more than 94% of patients received 80% or higher negative reports of opioid use during their second course of treatment.

An analysis of insurance claims found the 24-week cohort had a 27% decrease in unique hospital encounters compared with the 12-week group.

Sixty-four percent of the second prescription group completed all 32 core modules within the digital prescription, and 85% completed half of the core modules.

HOW IT WAS DONE

The study observed patients who were diagnosed with opioid use disorder and filled one prescription for reSET-O between January 2019 and December 2020 and a subpopulation who were prescribed a refill.

Patients were also treated with buprenorphine at clinics located in 12 different states. Researchers evaluated substance use through patient reports logged in the digital therapeutic and in-clinic urine screenings.

They also performed a retrospective analysis of health insurance claims to assess hospital encounters, which consisted of emergency room visits, observation, inpatient, intensive care unit and partial hospitalizations over nine months following the start of the first prescription.

THE BACKGROUND

Overdose deaths rose to record-breaking numbers in 2020, and synthetic opioids including fentanyl contributed to many of those deaths, according to a Commonwealth Fund analysis of CDC data. 

Pear’s reSET-O has been the subject of other studies. Earlier this month, a Pear-funded analysis published in the Journal of Market Access & Health Policy found the digital therapeutic lowered healthcare costs and added quality-adjusted life years. 

Another Pear study from August found patients who used reSET-O along with conventional treatment lowered their healthcare costs by $2,385 per person in the six months after they started using the app, compared with the six months before.

CONCLUSION

Researchers noted that data was captured directly by patients or clinicians, or recorded by digital therapeutic software, so that data came from a mixed population of patients who were at different stages of opioid treatment or may be using the digital therapeutic inconsistently.

Abstinence information was also directly reported by participants or derived from urine tests. The accuracy of the urine tests could be limited based on the frequency or timing of the tests. 

Though the researchers say the decision to prescribe a second course was driven by patients, there is a potential for selection bias in the 24-week cohort. Patients who requested a second course could have differed from the 12-week group, like being further along in their recovery.

The researchers said further research could control for some confounding factors, like creating cohort groups for gender, age and location.

“These analyses suggest that in a real-world population, patients with OUD had higher engagement with a refill prescription of a PDT vs. patients with one prescription filled, and showed durable and high levels of self-reported abstinence and treatment retention,” they wrote.

“Patients treated with the PDT for 24 weeks had a 27% lower rate of unique hospital encounters compared to those treated for 12 weeks.”