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Acceptability of the use of cellular telephone and computer pictures/video for “pill counts” in buprenorphine maintenance treatment

Christopher Welsh, MD

Abstract


Objective: As part of a comprehensive plan to attempt to minimize the diversion of prescribed controlled substances, many professional organization and licensing boards are recommending the use of “pill counts.” This study sought to evaluate acceptability of the use of cellular phone and computer pictures/video for “pill counts” by patients in buprenorphine maintenance treatment.

Setting and intervention: Patients prescribed buprenorphine/naloxone were asked a series of questions related to the type(s) of electronic communication to which they had access as well as their willingness to use these for the purpose of performing a “pill/film count.”

Results: Of the 80 patients, 4 (5 percent) did not have a phone at all. Only 28 (35 percent) had a “smart phone” with some sort of data plan and Internet access. Forty (50 percent) of the patients had a phone with no camera and 10 (12.5 percent) had a phone with a camera but no video capability. All patients said that they would be willing to periodically use the video or camera on their phone or computer to have buprenorphine/naloxone pills or film counted as long as the communication was protected from electronic tampering.

Conclusions: With the advent of applications for smart phones that allow for Health Insurance Portability and Accountability Act of 1996-compliant picture/video communication, a number of things can now be done that can enhance patient care as well as reduce the chances of misuse/diversion of prescribed medications. This could be used in settings where a larger proportion of controlled substances are prescribed including medication assisted therapy for opioid use disorders and pain management programs.


Keywords


pill counts, controlled substances, misuse, diversion

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References


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DOI: https://doi.org/10.5055/jom.2016.0334

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