PDT for Substance Use Disorder Yields High Engagement, Retention, Substance Abstinence

Pear Therapeutics announced new data from a real-world study demonstrating high rates of abstinence from substances among people with substance use disorder (SUD) using the reSET prescription digital therapeutic (PDT) through 12 weeks.

The observational analysis was published in The American Journal on Addictions and showed high rates of engagement and retention with reSET, which is currently the first and only FDA-approved PDT for treating SUD.

“Nearly half of people who begin a treatment program stop within the first three months, which makes it challenging to effectively treat patients throughout their entire recovery journey,” said Yuri Maricich, MD, MBA, chief medical officer, Pear Therapeutics, who worked on the real-world study. “The high rates of engagement and retention we observed in this analysis are especially encouraging as they demonstrate the potential benefit of reSET in treating patients in diverse and naturalistic real-world settings with substance use disorder, a population in need of effective therapies.”

This analysis of the PDT included 602 patients with SUD who were prescribed reSET for 12 weeks. The median age was 37 years, and the group was 33% female, 41% male, and 26% unreported sex.

The SUD treatment consisted of 61 therapy lessons and patients received positive reinforcement to continue with the treatment based on lesson completion and negative urine drug screens. The median number of lessons completed was 33 of 61, and 52% of patients completed all core modules.

Substance use was assessed through self-reports and urine screens. Engagement was defined as any activity with reSET and retention was defined as any activity in weeks 9 to 12. The researchers also looked for any associations between early lesson completion and end‐of‐treatment outcomes.

The researchers found high retention rates, with 74.6% of patients continuing to use the PDT in weeks 9 to 12.

They also discovered substantial rates of abstinence from substance use at the end of the 12 weeks. When missing data were entered as a positive urine screen, 62% of 602 patients with SUD abstained from substance use during the last 4 weeks of the trial. When missing data were excluded from the analysis, 86% of 434 patients abstained from substance use during that time.

Further, of the 258 patients using the SUD PDT appropriately—defined as an average of at least 4 lessons per week in weeks 1 to 4—81% were abstinent from substance use and 92% were retained with the PDT at 12 weeks.

The researchers noted multiple major limitations of these findings, including a lack of control group and possible heterogeneity in the patient population.

“Third, the PDT collects only minimal amounts of demographic data (ie, age, sex) and does not collect information related to the structure and format of treatment programs in which the patient is enrolled, nor about the nature of concurrent pharmaceutical and/or behavioral treatments being received,” they added. “This limits the ability to examine demographic subgroups or to discern any potential interactions associated with treatment context or receipt of other therapies.”

However, they also noted only 6.5% of patients with SUD receive any form of treatment for their condition, and that a convenient therapy like a PDT is necessary.

“These findings suggest the potential benefit of this PDT for treating patients with SUD, a population in need of more effective therapies,” the researchers concluded.

Reference

Xiong X, Braun S, Stitzer M, et al. Evaluation of real-world outcomes associated with use of a prescription digital therapeutic to treat substance use disorders. Am J Addict. Published online October 20, 2022. doi:10.1111/ajad.13346