scholarly journals A Literature Review Examining Primary Outcomes of Medication Treatment Studies for Opioid Use Disorder: What Outcome Should Be Used to Measure Opioid Treatment Success?

2020 ◽  
Vol 29 (4) ◽  
pp. 249-267
Author(s):  
Breanne E. Biondi ◽  
Xiaoying Zheng ◽  
Cynthia A. Frank ◽  
Ismene Petrakis ◽  
Sandra A. Springer
Keyword(s):  
Literature Review ◽  
Treatment Success ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Medication Treatment ◽  
Opioid Treatment

scholarly journals Fluctuations in barriers to medication treatment for opioid use disorder prescribing over the course of a one-year external facilitation intervention

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Allison M. Gustavson ◽  
Marie E. Kenny ◽  
Jennifer P. Wisdom ◽  
Hope A. Salameh ◽  
Princess E. Ackland ◽  
...  
Keyword(s):  
Implementation Strategies ◽  
Opioid Use Disorder ◽  
Veterans Health ◽  
Health Administration ◽  
Opioid Use ◽  
Medication Treatment ◽  
Conceptual Clarity ◽  
Parihs Framework ◽  
External Facilitation ◽  
Over Time

Abstract Background The Veterans Health Administration (VHA) is invested in expanding access to medication treatment for opioid use disorder (MOUD) to save lives. Access varies across VHA facilities and, thus, requires implementation strategies to promote system-wide adoption of MOUD. We conducted a 12-month study employing external facilitation that targeted MOUD treatment among low-adopting VHA facilities. In this study, we sought to evaluate the patterns of perceived barriers over 1 year of external implementation facilitation using the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. Methods We randomly selected eight VHA facilities from the bottom quartile of the proportion of Veterans with an OUD diagnosis receiving MOUD (< 21%). The 1-year external implementation intervention included developmental evaluation to tailor the facilitation, an on-site visit, and monthly facilitation calls. Facilitators recorded detailed notes for each call on a structured template. Qualitative data was analyzed by coding and mapping barriers to the constructs in the i-PARIHS framework (Innovation, Recipients, Context). We identified emerging themes within each construct by month. Results Barriers related to the Innovation, such as provider perception of the need for MOUD in their setting, were minimal throughout the 12-month study. Barriers related to Recipients were predominant and fluctuated over time. Recipient barriers were common during the initial months when providers did not have the training and waivers necessary to prescribe MOUD. Once additional providers (Recipients) were trained and waivered to prescribe MOUD, Recipient barriers dropped and then resurfaced as the facilities worked to expand MOUD prescribing to other clinics. Context barriers, such as restrictions on which clinics could prescribe MOUD and fragmented communication across clinics regarding the management of patients receiving MOUD, emerged more prominently in the middle of the study. Conclusions VHA facilities participating in 12-month external facilitation interventions experienced fluctuations in barriers to MOUD prescribing with contextual barriers emerging after a facilitated reduction in recipient- level barriers. Adoption of MOUD prescribing in low-adopting VHA facilities requires continual reassessment, monitoring, and readjustment of implementation strategies over time to meet challenges. Although i-PARIHS was useful in categorizing most barriers, the lack of conceptual clarity was a concern for some constructs.

Inpatient Opioid Use Disorder Treatment by Generalists is Associated With Linkage to Opioid Treatment Programs After Discharge

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Hannah R. Tierney ◽  
Christopher L. Rowe ◽  
Diana A. Coffa ◽  
Shashi Sarnaik ◽  
Phillip O. Coffin ◽  
...  
Keyword(s):  
Opioid Use Disorder ◽  
Treatment Programs ◽  
Opioid Use ◽  
Opioid Treatment ◽  
Disorder Treatment

scholarly journals Patient perceptions of treatment with medication treatment for opioid use disorder (MOUD) in the Vermont hub-and-spoke system

2019 ◽  
Vol 128 ◽  
pp. 105785 ◽  
Author(s):  
Richard A. Rawson ◽  
Traci Rieckmann ◽  
Sarah Cousins ◽  
Michael McCann ◽  
Regina Pearce
Keyword(s):  
Opioid Use Disorder ◽  
Patient Perceptions ◽  
Opioid Use ◽  
Hub And Spoke ◽  
Medication Treatment

Impact of Office-based Opioid Treatment on Emergency Visits and Hospitalization in Adolescents with Opioid Use Disorder

2020 ◽  
Vol 219 ◽  
pp. 236-242
Author(s):  
Kim S. Walker ◽  
Andrea E. Bonny ◽  
Erin R. McKnight ◽  
Milap C. Nahata
Keyword(s):  
Opioid Use Disorder ◽  
Opioid Use ◽  
Emergency Visits ◽  
Opioid Treatment

scholarly journals Medication treatment for opioid use disorder in the age of COVID-19: Can new regulations modify the opioid cascade?

2020 ◽  
pp. 108196
Author(s):  
Edward V. Nunes ◽  
Frances R. Levin ◽  
Muredach P. Reilly ◽  
Nabila El-Bassel
Keyword(s):  
Opioid Use Disorder ◽  
Opioid Use ◽  
Medication Treatment

scholarly journals Receipt of Timely Addiction Treatment and Association of Early Medication Treatment With Retention in Care Among Youths With Opioid Use Disorder

2018 ◽  
Vol 172 (11) ◽  
pp. 1029 ◽  
Author(s):  
Scott E. Hadland ◽  
Sarah M. Bagley ◽  
Jonathan Rodean ◽  
Michael Silverstein ◽  
Sharon Levy ◽  
...  
Keyword(s):  
Addiction Treatment ◽  
Retention In Care ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Medication Treatment

scholarly journals Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics): A cluster-randomized type 3 hybrid effectiveness-implementation trial

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Sara J. Becker ◽  
Cara M. Murphy ◽  
Bryan Hartzler ◽  
Carla J. Rash ◽  
Tim Janssen ◽  
...  
Keyword(s):  
Public Health ◽  
Patient Outcomes ◽  
The United States ◽  
Opioid Use Disorder ◽  
Treatment Programs ◽  
Opioid Use ◽  
Opioid Treatment ◽  
Implementation Outcomes ◽  
Cluster Randomized ◽  
Type 3

Abstract Background Opioid-related overdoses and harms have been declared a public health emergency in the United States, highlighting an urgent need to implement evidence-based treatments. Contingency management (CM) is one of the most effective behavioral interventions when delivered in combination with medication for opioid use disorder, but its implementation in opioid treatment programs is woefully limited. Project MIMIC (Maximizing Implementation of Motivational Incentives in Clinics) was funded by the National Institute on Drug Abuse to identify effective strategies for helping opioid treatment programs improve CM implementation as an adjunct to medication. Specific aims will test the impact of two different strategies on implementation outcomes (primary aim) and patient outcomes (secondary aims), as well as test putative mediators of implementation effectiveness (exploratory aim). Methods A 3-cohort, cluster-randomized, type 3 hybrid design is used with the opioid treatment programs as the unit of randomization. Thirty programs are randomized to one of two conditions. The control condition is the Addiction Technology Transfer Center (ATTC) Network implementation strategy, which consists of three core approaches: didactic training, performance feedback, and on-going consultation. The experimental condition is an enhanced ATTC strategy, with the same core ATTC elements plus two additional theory-driven elements. The two additional elements are Pay-for-Performance, which aims to increase implementing staff’s extrinsic motivations, and Implementation & Sustainment Facilitation, which targets staff’s intrinsic motivations. Data will be collected using a novel, CM Tracker tool to document CM session delivery, session audio recordings, provider surveys, and patient surveys. Implementation outcomes include CM Exposure (number of CM sessions delivered per patient), CM Skill (ratings of CM fidelity), and CM Sustainment (number of patients receiving CM after removal of support). Patient outcomes include self-reported opioid abstinence and opioid-related problems (both assessed at 3- and 6-months post-baseline). Discussion There is urgent public health need to improve the implementation of CM as an adjunct to medication for opioid use disorder. Consistent with its hybrid type 3 design, Project MIMIC is advancing implementation science by comparing impacts of these two multifaceted strategies on both implementation and patient outcomes, and by examining the extent to which the impacts of those strategies can be explained by putative mediators. Trial registration: This clinical trial has been registered with clinicaltrials.gov (NCT03931174). Registered April 30, 2019. https://clinicaltrials.gov/ct2/show/NCT03931174?term=project+mimic&draw=2&rank=1

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