Workload, Usability, and Engagement with a Mobile App Supporting Video Observation of Methadone Take-Home Dosing: A Usability Study (Preprint)

BACKGROUND Methadone, a cornerstone of opioid use disorder (OUD) treatments for many decades, is an essential tool for combatting the opioid epidemic. However, requirements for observing methadone dosing in-person via direct observed therapy (DOT) impose significant barriers for many patients. Digital technology can facilitate remote DOT, which could reduce barriers to methadone treatment. Currently, there are limited data on the usability of such technology among patients and counselors in methadone treatment settings. OBJECTIVE The primary objective of this study was to assess workload, usability, and engagement of a video-based DOT mobile application for patients with OUD receiving methadone treatment. The secondary objective was to assess workload, usability, and engagement of the provider-facing application portal used by counselors. METHODS Patients (n=12) and counselors (n=3) who previously trialed video DOT for methadone via a smartphone application in an opioid treatment program (OTP) participated in usability testing sessions. Participants completed essential tasks for video DOT, then provided ratings of workload (NASA Task Load Index), usability (Modified System Usability Scale), and engagement (Modified Engagement Scale) with the core features of the video DOT program. RESULTS Patients and counselors reported low mental, physical, and temporal demands, successful performance, low effort, and low frustration associated with activities. Patients reported high usability (mean=85, SD=9.5) and engagement (mean=3.8, SD=1.1); counselors reported moderate usability (mean=43.3, SD=17.7) and engagement (mean=2.81, SD=0.63). CONCLUSIONS A mobile health application that facilitates video-based DOT of methadone required low workload for patients and counselors and was highly usable to patients in an OTP; however, there are opportunities to improve usability and engagement for the counselor-facing portal. CLINICALTRIAL Not applicable