The Role of Primary Care in Improving Access to Medication-Assisted Treatment for Rural Medicaid Enrollees with Opioid Use Disorder

Cole, Evan S.; DiDomenico, Ellen; Cochran, Gerald; Gordon, Adam J.; Gellad, Walid F.; Pringle, Jan; Warwick, Jack; Chang, Chung Chou H.; Kim, Joo Yeon; Kmiec, Julie; Kelley, David; Donohue, Julie M.

doi:10.1007/s11606-019-04943-6

Cited by 49 publications

(45 citation statements)

References 13 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Identified barriers should also be taken into consideration in the design of opioid improvement initiatives in rural settings, in particular providing data system solutions and efforts that address resource deficits. Finally, while recent studies support the efficacy of medications for opioid use disorder in rural areas [25][26][27], there is a pressing need for more research on effective strategies for screening, diagnosis, and management of this condition among patients in rural areas who are on LtOT.…”

Section: Resultsmentioning

confidence: 99%

Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics

Parchman

Ike

Osterhage

et al. 2020

J. Clin. Trans. Sci.

View full text Add to dashboard Cite

Background: Opioids are more commonly prescribed for chronic pain in rural settings in the USA, yet little is known about how the rural context influences efforts to improve opioid medication management. Methods: The Six Building Blocks is an evidence-based program that guides primary care practices in making system-based improvements in managing patients using long-term opioid therapy. It was implemented at 6 rural and rural-serving organizations with 20 clinic locations over a 15-month period. To gain further insight about their experience with implementing the program, interviews and focus groups were conducted with staff and clinicians at the six organizations at the end of the 15 months and transcribed. Team members used a template analysis approach, a form of qualitative thematic analysis, to code these data for barriers, facilitators, and corresponding subcodes. Results: Facilitators to making systems-based changes in opioid management within a rural practice context included a desire to help patients and their community, external pressures to make changes in opioid management, a desire to reduce workplace stress, external support for the clinic, supportive clinic leadership, and receptivity of patients. Barriers to making changes included competing demands on clinicians and staff, a culture of clinician autonomy, inadequate data systems, and a lack of patient resources in rural areas. Discussion: The barriers and facilitators identified here point to potentially unique determinants of practice that should be considered when addressing opioid prescribing for chronic pain in the rural setting.

show abstract

Section: Resultsmentioning

confidence: 99%

Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics

Parchman

Ike

Osterhage

et al. 2020

J. Clin. Trans. Sci.

View full text Add to dashboard Cite

show abstract

“…The need for increased clinical capacity to provide buprenorphine is well-documented, especially in rural settings. 36 Research about barriers faced by providers to providing buprenorphine point to institutional support as a key factor. 10 , 11 Moreover, research on physician satisfaction and burnout has documented that provider job satisfaction is affected by providers’ perceived ability to provide compassionate healthcare, and by minimizing the “professional dissonance” between clinical goals (e.g., improving patient health) and institutional ones (e.g., maximizing revenue).…”

Section: Discussionmentioning

confidence: 99%

A Harm Reduction Approach to Treating Opioid Use Disorder in an Independent Primary Care Practice: a Qualitative Study

et al. 2021

View full text Add to dashboard Cite

“…Age at hospitalization was used to identify beneficiaries aged ≥65 years. Using previously published ICD-10 codes for OUD, 4 we identified the presence of OUD on inpatient claims after randomly sampling 1 hospitalization per person. For comparison, we examined characteristics among hospitalized patients without an OUD-related hospitalization.…”

Section: Methodsmentioning

confidence: 99%

Opioid Use Disorder Among Hospitalized Older Adults: Prevalence, Characteristics, and Discharge Status

Zullo

Moyo

Jutkowitz

et al. 2020

Journal of the American Medical Directors Association

View full text Add to dashboard Cite

The Role of Primary Care in Improving Access to Medication-Assisted Treatment for Rural Medicaid Enrollees with Opioid Use Disorder

Cited by 49 publications

References 13 publications

Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics

Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics

A Harm Reduction Approach to Treating Opioid Use Disorder in an Independent Primary Care Practice: a Qualitative Study

Opioid Use Disorder Among Hospitalized Older Adults: Prevalence, Characteristics, and Discharge Status

Contact Info

Product

Resources

About