Duke University has received about $500,000 in grant money from Blue Cross Blue Shield of North Carolina to build an app designed to help doctors and patients work together to prevent opioid abuse.

The investment is part of $2 million in grants distributed earlier this week by Blue Cross NC across five organizations tackling the opioid crisis in different ways, which in turn is part of a $10 million investment in fighting opioid abuse announced last year.

Duke’s program, called Symmetry, is based on the idea of asking patients to be a partner in their care, according to Dr. Arif Kamal, physician quality officer at the Duke Cancer Institute and leader of the project.

“If you take the approach that most people are not trying to get addicted and you focus in on those folks and really work hard to help them understand ‘What are the behaviors that you start to see in yourself that we need to know about so we can do things slightly differently?’, then we’re asking our patients to be engaged partners in preventing opioid abuse and addiction,” Kamal told MobiHealthNews. “Because at the end of the day, it’s their lives we are trying to save and we want them to be a part of that process.”

The team hopes to have a beta of the app ready within a year, to have pilot studies completed a year after that and then to take the technology on the road to promote adoption in different care settings.

The app will include videos and other educational content teaching patients about how to take their medications, how to watch for signs of addiction, how to store and dispose of pills and more. It will also include an electronic diary that clinicians will be able to monitor on a dashboard in real time.

“Right now the status quo for clinicians is we have to be, to a certain extent, investigators,” Kamal said. “We have to listen to peoples’ stories and if they say ‘The last five pills I tried to pour into my pillbox accidentally fell down the sink’ we’re forced to look at that person and try to figure out ‘Do we believe that story or not?’ And this is a daily challenge for clinicians.”

Having the data provided by a diary app will help doctors make those calls with more and better data. It will also (along with the educational components) help combat accidental underdosing and overdosing that otherwise might not be caught until the patient’s next appointment.

Why it matters

Opioids were responsible for more than 70,000 deaths in 2017, up from 40,000 in 2016. The combination of overprescription and insufficient treatment resources have led to a rising epidemic that disproportionately affects midwestern and rural America. 

Many organizations in the public and private sectors are working on the problem, but Kamal believes Symmetry attacks it from an important and under-examined axis.

“It’s part of the solution,” he said. “There’s other things that need to be done as well, but we were surprised that there’s not widescale use of processes that standardize [opioid prescription] so that patients don’t feel selected or we’re not using intuition as much; we’re using more data to make decisions.”

What’s the trend

As we’ve noted in the past, combatting the opioid crisis has become the signature medical issue of the Trump administration, with initiatives to fight the epidemic arising in an HHS code-a-thon, a CDC blockchain pilot with IBM, rare bipartisan legislation to improve telemedicine and e-prescribing resources, an FDA innovation competition and more.

On the record

In North Carolina alone, three people die every day from an opioid overdose,” Dr. Anuradha Rao-Patel, Blue Cross NC lead medical director and acute and chronic pain management specialist, said in a statement “We are proud to invest in these … organizations that are working so diligently to combat the opioid epidemic in our state and its far-reaching impact felt by nearly every North Carolinian.”