From policy to practice: Pilot program increases access to medication for opioid use disorder in rural Colorado

Sorrell, Tanya; Weber, Mary Kate; Alvarez, Andrea; Beste, Nancy; Hollins, Ursula; Amura, Claudia R.; Cook, Paul F.

doi:10.1016/j.jsat.2020.108027

Cited by 12 publications

(27 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Baseline patient characteristics in this study are presented in Table 1. Overall, demographics were similar between patients who remained in treatment for at least 6 months (evaluable patients) and those lost to follow-up (non-evaluable, also comparable to the whole population) [7]. On average, evaluablepatients were adults 25 to 44 years old (61.6%), not married (78.9%), White (57.0%) or Hispanic (36.7%), had completed approximately 12.5 years of education (48.5% had completed high school), and had Medicaid insurance coverage (86.9%).…”

Section: Patient Characteristicsmentioning

confidence: 80%

“…The clinics in this study serve a racially and ethnically diverse patient population with a mix of health insurance and living experiences. As reported elsewhere [7], patients seeking MOUD services were over 18 years old and met OUD clinical criteria. Prior to starting MOUD, patients underwent a clinical interview by trained staff and consented to receive treatment and to have their clinical information aggregated as part of program evaluation.…”

Section: Participantsmentioning

confidence: 84%

“…Three community clinics received funding between 2017 and 2019: a methadone clinic that added buprenorphine to its services, a community mental health center that expanded its existing MOUD services, and a startup clinic that provided MOUD as part of a multidisciplinary pain services [7]. Service delivery began on December 1, 2017.…”

Section: Settings and Program Implementationmentioning

confidence: 99%

“…Process data were collected monthly from each of the program sites during the duration of the pilot and for up to 6 additional months for patient follow up. Aggregated agency-level data were analyzed based on monthly reports about services provided, successes, and barriers for implementation and patient retention, and used to answer process evaluation questions [7].…”

Section: Procedures and Instrumentsmentioning

confidence: 99%

“…Between December 2017 and June 2019, the University of Colorado College of Nursing (CU Nursing) worked to engage rural clinics, train providers, and implement a MOUD pilot program in Pueblo and Routt counties. The program added 15 nurse practitioners and physician assistants to the MOUD workforce and served 1005 new patients during the rst 18 months [7]. Although the legislation was designed primarily to increase access, CU Nursing and community stakeholders also wanted to know to what extent the program was helping patient's lives, including mental and physical health, social functioning, employment, disability, and legal system involvement.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Outcomes from the Medication Assisted Treatment Pilot Program for Adults With Opioid Use Disorders in Rural Colorado

Amura

Sorrell

Weber

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

Background. As Colorado ranked among the top nationally in non-medical use of opioids, a pilot medication for opioid use disorder (MOUD) program was developed to increase the number of NPs and PAs providing MOUD in order to bring this evidence based treatment 2 counties showing disproportionally high opioid overdose deaths. Over the first 18 months, the MOUD Pilot Program led to 15 new health care providers receiving MOUD waiver training and 1,005 patients receiving MOUD from the 3 participating organizations. Here we evaluate the impact of the pilot MOUD program implemented in 2 rural counties severely affected by the opioid crisis on patient centered clinical and functional outcomes. Methods. Under state-funded law, three rural agencies submitted patient-level data at baseline (N = 1005) and after 6 months of treatment (N = 190, 25%) between December 2017 and January 2020. The Addiction Severity Index with McNemar-Bowker and t tests were used to measure program impact. Results. Patients in treatment reported using less heroin (13.0 vs. 3.7 days), opioids (3.7 vs. 1.9 days), and alcohol (3.2 vs 0.7 days, all P < 0.01). Patients reported improved health (53.4% vs. 68.2%, P = 0.04), less days of disability (8.69 vs. 6.51, P = 0.02), symptoms (29.8% vs 21.3%), pain (67.5 % to 53.6), worry (45.3% vs 62.3%), anxiety (49.7% vs 23.2%), depression (54.1% vs 23.3%, all P < 0.02) after treatment. Conclusions. This study shows decreased substance use, improved physical and mental health, and reduced symptoms after 6 months of MOUD. Although more research on retention and long-term effects is needed, data shows improved health outcomes after 6 months of MOUD. Lessons learned from implementing this pilot program informed program expansion into other rural areas in need to address some of Colorado’ major public health crises.

show abstract

Section: Patient Characteristicsmentioning

confidence: 80%

Section: Participantsmentioning

confidence: 84%

Section: Settings and Program Implementationmentioning

confidence: 99%

Section: Procedures and Instrumentsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Outcomes from the Medication Assisted Treatment Pilot Program for Adults With Opioid Use Disorders in Rural Colorado

Amura

Sorrell

Weber

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

Prescriptions for Buprenorphine in Michigan Following an Education Intervention

Chen,

Sethi,

Poland

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceBuprenorphine is an underused treatment for opioid use disorder (OUD) that can be prescribed in general medical settings. Founded in 2017, the Michigan Opioid Collaborative (MOC) is an outreach and educational program that aims to address clinician and community barriers to buprenorphine access; however, the association between the MOC and buprenorphine treatment is unknown.ObjectiveTo evaluate the association between MOC service use and county-level temporal trends of density of buprenorphine prescribers and patients receiving buprenorphine.Design, Setting, and ParticipantsThis cohort study exploited staggered implementation of MOC services across all Michigan counties. Difference-in-difference analyses were conducted by applying linear fixed-effects regression across all counties to estimate the overall association of MOC engagement with outcomes and linear regression for each MOC-engaged county separately to infer county-specific results using data from May 2015 to August 2020. Analyses were conducted from September 2021 to November 2023.ExposuresMOC engagement.Main Outcomes and MeasuresCounty-level monthly numbers of buprenorphine prescribers and patients receiving buprenorphine (per 100 000 population).ResultsAmong 83 total counties, 57 counties (68.7%) in Michigan were engaged by MOC by 2020, with 3 (3.6%) initiating engagement in 2017, 19 (22.9%) in 2018, 27 (32.5%) in 2019, and 8 (9.6%) in 2020. Michigan is made up of 83 counties with a total population size of 9 990 000. A total of 5 070 000 (50.8%) were female, 1 410 000 (14.1%) were African American or Black, 530 000 (5.3%) were Hispanic or Latino, and 7 470 000 (74.7%) were non-Hispanic White. The mean (SD) value of median age across counties was 44.8 (6.4). The monthly increases in buprenorphine prescriber numbers in the preengagement (including all time points for nonengaged counties) and postengagement periods were 0.07 and 0.39 per 100 000 population, respectively, with the absolute difference being 0.33 (95% CI, 0.12-0.53) prescribers per 100 000 population (P = .002). The numbers of patients receiving buprenorphine increased by an average of 0.6 and 7.15 per 100 000 population per month in preengagement and postengagement periods, respectively, indicating an estimated additional 6.56 (95% CI, 2.09-11.02) patients receiving buprenorphine per 100 000 population (P = .004) monthly increase after engagement compared with before.Conclusions and RelevanceIn this cohort study measuring buprenorphine prescriptions in Michigan over time, counties’ engagement in OUD-focused outreach and clinician education services delivered by a multidisciplinary team was associated with a temporal increase in buprenorphine prescribers and patients receiving buprenorphine.

show abstract

Engagement in drug treatment following nonfatal overdose among people who inject drugs in Appalachia

Allen

Wedlock

White

et al. 2021

International Journal of Drug Policy

View full text Add to dashboard Cite

From policy to practice: Pilot program increases access to medication for opioid use disorder in rural Colorado

Cited by 12 publications

References 13 publications

Outcomes from the Medication Assisted Treatment Pilot Program for Adults With Opioid Use Disorders in Rural Colorado

Outcomes from the Medication Assisted Treatment Pilot Program for Adults With Opioid Use Disorders in Rural Colorado

Prescriptions for Buprenorphine in Michigan Following an Education Intervention

Engagement in drug treatment following nonfatal overdose among people who inject drugs in Appalachia

Contact Info

Product

Resources

About