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- Page navigation anchor for RE: Increasing Capacity for Treatment of Opioid Use Disorder in Rural Primary Care PracticesRE: Increasing Capacity for Treatment of Opioid Use Disorder in Rural Primary Care Practices
It is certainly undeniable that opioid use disorder (OUD) is a significant crisis in the United States, especially in rural communities. Importantly, rural opioid-related mortality rates have increased over 600% in non-metropolitan counties over the last twenty years.1 It is crucial that more attention is drawn to this issue, as in many parts of the country, patients are viewed through the lens of the stigma that is often associated with addiction. As evidenced by your findings, IT MATTTRs training enables primary care teams to deliver quality treatment, specifically with buprenorphine, to those suffering from OUD. The results show that the number of patients with a buprenorphine prescription increased significantly because of the IT MATTTRs program. The most important conclusion that can be drawn from these findings is that the IT MATTTRs program can truly affect the approach primary care teams take regarding OUD treatment.
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Furthermore, it is vital that primary care practice-based networks included in the study were able to successfully implement parts of the IT MATTTRs program needed to increase treatment delivery. This demonstrates that the program was reasonable for a practice to follow, suggesting that practices with similar resources in other locations may be able to enact similar policies. Although specific data from each practice was not provided as part of this report, available data indicates that the IT MATTTRS program was able to reach the goal of increas...Competing Interests: None declared. - Page navigation anchor for RE: Journal Club discussion on Increasing Capacity for Treatment of Opioid Use Disorder in Rural Primary Care PracticesRE: Journal Club discussion on Increasing Capacity for Treatment of Opioid Use Disorder in Rural Primary Care Practices
The overall purpose of this study was to analyze the implementation of an intervention designed to improve awareness, adoption, and utilization of buprenorphine treatment of opioid use disorder (OUD). Implementing Technology and Medication Assisted Treatment Team Training in Rural Colorado (IT MATTTRs) is a practice-focused training program that covered the pharmacology of buprenorphine, epidemiology of OUD, neurobiology of addiction, and buprenorphine treatment steps. Training included members of the entire health care team, such as physicians, nurses, and office staff.
This program used components of the RE-AIM evaluation framework to examine outcomes at the patient, practice, and community levels. The study was conducted across 16 counties in eastern Colorado, many of which are federally qualified health centers. Implementation of IT MATTTRs was analyzed using an implementation checklist of items that support treatment using buprenorphine. There was also data from a practice report that collected practice-level data, including data on the number of new inductions and the number of patients prescribed buprenorphine. Population-based data was assessed using the Colorado Prescription Drug Monitoring Program.
When assessing the results, it was clear to the group that this program was effective at significantly increasing the proportion of patients prescribed buprenorphine and receiving treatment for 6 or more months. Many items measured using the implementat...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: Increasing Capacity for Treatment of Opioid Use Disorder in Rural Primary Care PracticesRE: Increasing Capacity for Treatment of Opioid Use Disorder in Rural Primary Care Practices
Thank you to Linda Zittleman and colleagues for this description of an excellent example of translational research and for your efforts to improve care for people with opioid use disorders. I am familiar with this project, having served on an advisory group for all grantees in this program and by working with some of the authors on community engagement.
This paper reminded me of some key principles of successful translation of research into practice - engaging the whole practice team, packaging the intervention in a way that facilitates adoption, and doing a community intervention in parallel to raise awareness and increase community acceptance of the intervention.
The authors also do a very good job of measuring the impact of their intervention at multiple levels. Combining practice level process measures with population level prescription data is interesting and suggests that the region achieved results beyond those in other parts of the state. It is impressive to see how much practice change was accomplished, given that there are always competing demands on clinician and practice time and attention.
Thanks to the authors for a well done study.Competing Interests: I was an advisor to this project in my role on an expert panel working with AHRQ. I have also worked with some of the authors who have mentored me and other colleagues on community engaged research. I have no financial conflicts.