Medications for Opioid Use Disorder in Rural Primary Care Practices: Patient and Provider Experiences

Bridges, Nora C.; Taber, Rachel; Foulds, Abigail; Bear, Todd; Cloutier, Renee M.; McDonough, Brianna L.; Gordon, Adam J.; Cochran, Gerald; Donohue, Julie M.; Adair, Dale; DiDomenico, Ellen; Pringle, Jan; Gellad, Walid F.; Kelley, David; Cole, Evan S.

doi:10.2139/ssrn.4279149

Cited by 2 publications

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“…Interventions should address not only treatment recommendations and logistics but also community and professional stigma related to individuals with OUD. 22 - 24 It is crucial to communicate up-to-date information on local OUD prevalence and OBOT utilization, while providing clear and unbiased advice for diagnosing OUD 25 and discussing OBOT with patients. 26…”

Section: Recommendationsmentioning

confidence: 99%

Network Analysis of Medical Claims Data Suggests Network-Based, Regional Targeting and Intervention Delivery Strategies to Increase Access to Office Based Opioid Treatment (OBOT) for Opioid Use Disorder (OUD)

Green,

Kaminski

2024

INQUIRY

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Opioid overdose and Opioid Use Disorder (OUD) statistics underscore an urgent need to significantly expand access to evidence-based OUD treatment. Office Based Opioid Treatment (OBOT) has proven effective for treating OUD. However, limited access to these treatments persists. Recognizing the need for significant investment in clinical, behavioral, and translational research, the Indiana State Department of Health and Indiana University embarked on a research initiative supported by the “Responding to the Addictions Crisis” Grand Challenge Program. This brief presents recommendations based on existing research and our own analyses of medical claims data in Indiana, where opioid misuse is high and treatment access is limited. The recommendations cover target providers, intervention focus, priority regions, and delivery methods.

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Section: Recommendationsmentioning

confidence: 99%

Network Analysis of Medical Claims Data Suggests Network-Based, Regional Targeting and Intervention Delivery Strategies to Increase Access to Office Based Opioid Treatment (OBOT) for Opioid Use Disorder (OUD)

Green,

Kaminski

2024

INQUIRY

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“…The current article focuses only on responses related to motivations to engage in Project RAMP. A more detailed description of the methodology and comprehensive KII results related to implementation outcomes will be reported separately (Bridges et al, 2022).…”

Section: Key Informant Interviews (Kiis)mentioning

confidence: 99%

Strategies to recruit rural primary care providers to implement a medication for opioid use disorder (MOUD) focused integrated care model

Cloutier

Cole

McDonough

et al. 2023

Implementation Research and Practice

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Background Access to providers and programs that provide medications for opioid use disorder (MOUD) remains a systemic barrier for patients with opioid use disorder (OUD), particularly if they live in rural areas. The Rural Access to Medication Assisted Treatment (MAT) in Pennsylvania Project (Project RAMP) addressed this problem with a multisystem partnership that recruited, trained, and supported rural primary care providers to provide MOUD and implement an integrated care model (ICM) for patients with OUD. Given the demonstrated efficacy of Project RAMP, this article summarizes our recruitment strategies, including feasibility concerns for further expansion into other regions. Methods The approach for recruiting implementation sites included two phases: partner outreach and site identification. Once recruited, the Systems Transformation Framework guided planning and implementation activities. Recruitment and implementation activities were assessed with implementation trackers and evaluated by providers via key informant interviews (KIIs). Results Project RAMP recruited 26 primary care practices from 13 counties, including nine health systems and two private practice groups—exceeding the original target of 24 sites. There was a median of 49 days from first contact to project onboarding. A total of 108 primary care practices spanning 22 health systems declined participation. Findings from the KIIs highlighted the value of engaging PCPs by connecting to a shared vision (i.e., improving the quality of patient care) as well as addressing perceived participation barriers (e.g., offering concierge technical assistance to address lack of training or resources). Conclusion Findings highlight how successful recruitment activities should leverage the support of health system leadership. Findings also emphasize that aiding recruitment and engagement efforts successfully addressed prescribers’ perceived barriers to providing MOUD as well as facilitating better communication among administrators, PCPs, behavioral health professionals, care managers, and patients. Plain Language Summary: Opioid use disorder (OUD) is one of the leading causes of preventable illness and death. The standard of care for OUD is the provision of medications for opioid use disorder (MOUD) and the application of an integrative integrated care model (ICM) where behavioral health is blended with specialized medical services. Unfortunately, access to providers and healthcare facilities that provide MOUD or apply an ICM remains a systemic barrier for patients with OUD, particularly if they live in rural areas. Although there is no one-size-fits-all approach to implementing MOUD in primary care, findings from Project The Rural Access to Medication Assisted Treatment (MAT) in Pennsylvania Project (Project RAMP) highlight strategies that may improve future MOUD and ICM implementation efforts in similar rural contexts. Specifically, future efforts to increase MOUD capacity by recruiting new providers should be prepared to leverage health system leadership, address provider barriers via training and expert consultation, and facilitate connections to local behavioral health providers. This approach may be helpful to others recruiting health systems and primary care practices to implement new care models to use MOUD in treating patients with OUD.

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Medications for Opioid Use Disorder in Rural Primary Care Practices: Patient and Provider Experiences

Cited by 2 publications

References 0 publications

Network Analysis of Medical Claims Data Suggests Network-Based, Regional Targeting and Intervention Delivery Strategies to Increase Access to Office Based Opioid Treatment (OBOT) for Opioid Use Disorder (OUD)

Network Analysis of Medical Claims Data Suggests Network-Based, Regional Targeting and Intervention Delivery Strategies to Increase Access to Office Based Opioid Treatment (OBOT) for Opioid Use Disorder (OUD)

Strategies to recruit rural primary care providers to implement a medication for opioid use disorder (MOUD) focused integrated care model

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