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Enrolling by Invitation

NCT Number: NCT07620171

Peer Recovery Support for Opioid Use Disorder Treatment Retention

The goal of this clinical trial is to learn whether adding peer recovery support services to standard opioid use disorder (OUD) treatment in primary care helps patients stay in treatment longer. The main question it seeks to answer is whether it is feasible to deliver a peer recovery support intervention alongside medication-assisted treatment (buprenorphine) in a Philadelphia primary care clinic.

Participants will receive standard OUD treatment (buprenorphine) combined with peer recovery support services for 180 days. They will attend study visits at baseline, weekly for the first 2 weeks, then every 2 weeks, then monthly, and complete assessments about substance use, medication adherence, self-efficacy, resilience, and coping. Participants will also take part in brief periodic interviews about their experience with peer support.

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Key information

Conditions

Opioid Use Disorder Buprenorphine Chemically-Induced Disorders Mental Disorders Narcotic-Related Disorders Opioid-Related Disorders Peer Recovery Coaching Peer Recovery Supporters Primary Care Substance-Related Disorders

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Penn Family Medicine

Philadelphia, Pennsylvania, 19104, United States

About this study

Opioid use disorder (OUD) is a chronic, relapsing condition associated with substantial morbidity, mortality, and social burden. Buprenorphine, delivered in primary care settings, is an evidence-based treatment for OUD, yet treatment dropout remains a critical barrier to recovery. Many patients disengage during the early weeks following induction, before buprenorphine has had the opportunity to stabilize their condition. Peer recovery support (PRS) services, provided by individuals with lived experience of addiction and recovery, represent a promising strategy to improve retention, but the evidence base for optimized peer interventions in primary care OUD treatment remains limited.

The peer intervention evaluated in this study was developed through a systematic optimization process conducted in partnership with OUD, peer, and implementation experts, with extensive input from patients, practitioners, and community stakeholders. Intervention design drew on surveys and qualitative studies of Philadelphia-region OUD treatment programs with existing peer support services, as well as best practices from community health worker models in other chronic disease settings. Component elements, including peer qualifications, supervision structure, training curriculum, caseload size, scope of services, and care team integration, were systematically evaluated and refined prior to the pilot.

The resulting intervention is organized around five core structural elements: (1) clinically integrated supervision with structured case review; (2) standardized recruitment and hiring practices emphasizing empathy, problem-solving capacity, and community engagement; (3) a competency-based training curriculum covering psychosocial support, crisis response, stigma, interprofessional ethics, social determinants of health, and system navigation; (4) stage-tailored peer-patient contact, with intensive engagement during the high-dropout early induction period transitioning to stabilization-focused support as treatment progresses; and (5) active peer wellness practices to mitigate compassion fatigue and burnout.

This pilot study will evaluate the feasibility, acceptability, and operational implementation of the intervention within primary care-based buprenorphine treatment programs and generate data to inform a future randomized controlled trial.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 18 years or older
  • Diagnosis of opioid use disorder (OUD)
  • Currently receiving or initiating buprenorphine treatment from a primary care physician
  • Able to communicate in English
  • Access to a phone
  • Able and willing to provide written informed consent

Exclusion criteria

  • Acute suicidal ideation or intent
  • Active mania or psychotic episode
  • Significant cognitive impairment

Treatment and study plan

Peer Support

Behavioral

Peer recovery support services delivered by trained, certified peers with lived experience of opioid use disorder, added to standard medication-assisted treatment (buprenorphine) in a primary care setting. Peer services are structured around three stages of OUD treatment (initial engagement, early treatment, and stable treatment) with contact intensity tailored to dropout risk at each stage (approximately 2 contact hours/week during initial engagement). Contact modalities include in-office meetings, phone calls, texts, and appointment reminders. Peers are supervised and integrated as full members of the clinical care team. The intervention was developed with input from OUD, peer, and implementation experts and informed by qualitative and survey data from Philadelphia-region OUD treatment programs. Caseload: approximately 15 patients per peer. Duration: 180 days.

Primary outcomes

  1. OUD treatment retention

    Time frame: 180 days

    Retention in OUD treatment measured as time in days from treatment initiation (buprenorphine induction) to dropout (unplanned treatment termination) or treatment completion over the 180-day study period.

Secondary outcomes

  1. Self-report opioid use

    Time frame: 180 days

    Assessed using an abbreviated 30-day Time-Line Follow-Back (TLFB) instrument capturing self-reported opioid use at each study visit.

  2. Buprenorphine adherence

    Time frame: 180 days

    Assessed using the Brief Medication Questionnaire (self-report).

  3. Resilience, coping, and self-efficacy

    Time frame: 180 days

    A 30-item composite questionnaire combining three patient-centered outcome domains to minimize participant burden. Section 1 (Resilience, 10 items) uses a 5-point Likert scale rating the past month, with 4 items reverse-scored; scores range from 10 to 50, with higher scores indicating greater resilience. Section 2 (Coping Strategies, 10 items adapted from the Brief COPE) uses a 4-point scale rating frequency of coping strategy use, including a substance use item; scores range from 10 to 40, with higher scores indicating greater frequency of coping strategy use. Section 3 (Abstinence Self-Efficacy, 10 items adapted from the Alcohol Abstinence Self-Efficacy Scale) uses a 5-point confidence scale assessing ability to remain opioid-free across situational triggers over the past week; scores range from 10 to 50, with higher scores indicating greater confidence in maintaining opioid abstinence.

  4. Opioid urine drug screen positivity

    Time frame: 180 days

    Proportion of urine drug screens positive for opioids, obtained at routine clinical visits throughout the study period.

Sponsors and collaborators

Lead sponsor

University of Pennsylvania

Other

Collaborators

  • National Institute on Drug Abuse (NIDA)

Registry information

Official study title

Reducing OUD Treatment Dropout: Development and Pilot Test of a Peer Recovery Support Intervention in Primary Care

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jun 2, 2026
Registry last updated
Jun 2, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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