Video observed therapy to enhance flexibility and reduce in-person visits for patients treated with methadone in a multi-site opioid treatment program

Methadone is an effective treatment for opioid use disorder (OUD) yet historically the care delivery model requires directly-observed therapy (DOT) at opioid treatment programs which is a barrier to clients. Many factors ultimately led to the revision of regulations, paving the way for more flexible models of care. Our prior Phase I research demonstrated the feasibility, safety, and acceptability of an innovative mobile health platform to provide asynchronous, video DOT and to screen for symptoms of disease for patients treated for OUD with methadone; this proposal aims to test the implementation of video direct observe therapy (video-DOT) for methadone across a large, multisite OTP organization via a Hybrid Type 2 Effectiveness Implementation study with stepped wedge cluster randomized trial design.