Co-occurring implementation strategies: The effects of academic detailing for opioid use disorder campaign on the advancing pharmacological treatments for opioid use disorder (ADaPT-OUD) study
Background Barriers at the system, clinician, and patient level limit access to medications for opioid use disorder (MOUD). The Advancing Pharmacological Treatments for Opioid Use Disorder (ADaPT-OUD) study implemented an external facilitation strategy within the Veterans Health Administration (VHA)...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-09-01
|
| Series: | Implementation Research and Practice |
| Online Access: | https://doi.org/10.1177/26334895231199463 |
| _version_ | 1797683941881151488 |
|---|---|
| author | Wendy A. Miller Adam J. Gordon Barbara A. Clothier Princess E. Ackland Mark Bounthavong Carla Garcia Marie E. Kenny Siamak Noorbaloochi Hildi J. Hagedorn |
| author_facet | Wendy A. Miller Adam J. Gordon Barbara A. Clothier Princess E. Ackland Mark Bounthavong Carla Garcia Marie E. Kenny Siamak Noorbaloochi Hildi J. Hagedorn |
| author_sort | Wendy A. Miller |
| collection | DOAJ |
| description | Background Barriers at the system, clinician, and patient level limit access to medications for opioid use disorder (MOUD). The Advancing Pharmacological Treatments for Opioid Use Disorder (ADaPT-OUD) study implemented an external facilitation strategy within the Veterans Health Administration (VHA) aimed at facility-level barriers to improve uptake of MOUD. During ADaPT-OUD, an independent Academic Detailing Services Opioid Agonist Treatment of OUD Campaign was co-occurring and aimed to increase evidence-based practice for OUD at the clinician level. While both these initiatives aim to increase MOUD reach, they address different barriers and did not intentionally collaborate. Thus, understanding the interaction between these two independent implementation initiatives and their effect on MOUD reach will further inform and mold future implementation efforts of MOUD. Methods This was a secondary analysis of the ADaPT-OUD study that included 35 VHA facilities in the lowest quartile of MOUD reach; eight received the ADaPT-OUD external facilitation and 27 matched sites received implementation as usual. The number of academic detailing (AD) visits during ADaPT-OUD was used as a proxy for the intensity of Academic Detailing for OUD Campaign activity. The interaction between external facilitation status and AD intensity was evaluated by comparing the change in facility-level MOUD reach. Results There was a general increase in the number of AD visits, in both external facilitation and implementation as usual sites, over the course of ADaPT-OUD's implementation period. A non-statistically significant, positively sloped, linear relationship was observed between average number of AD visits per quarter and change in MOUD reach in facilities also receiving ADaPT-OUD external facilitation that was not observed in the implementation as usual sites. Conclusion Co-occurring initiatives focusing on different barriers to MOUD access have the potential to further increase MOUD in low-performing facilities, but further research into timing, quality, and collaboration between initiatives are warranted. |
| first_indexed | 2024-03-12T00:22:12Z |
| format | Article |
| id | doaj.art-7e1b2681f3b44296b54a7da5ec11a4ec |
| institution | Directory Open Access Journal |
| issn | 2633-4895 |
| language | English |
| last_indexed | 2024-03-12T00:22:12Z |
| publishDate | 2023-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Implementation Research and Practice |
| spelling | doaj.art-7e1b2681f3b44296b54a7da5ec11a4ec2023-09-15T13:03:27ZengSAGE PublishingImplementation Research and Practice2633-48952023-09-01410.1177/26334895231199463Co-occurring implementation strategies: The effects of academic detailing for opioid use disorder campaign on the advancing pharmacological treatments for opioid use disorder (ADaPT-OUD) studyWendy A. Miller0Adam J. Gordon1Barbara A. Clothier2Princess E. Ackland3Mark Bounthavong4Carla Garcia5Marie E. Kenny6Siamak Noorbaloochi7Hildi J. Hagedorn8 Department of Medicine, University of Minnesota, Minneapolis, MN, USA Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), University of Utah School of Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA Department of Medicine, University of Minnesota, Minneapolis, MN, USA Skaggs School of Pharmacy & Pharmaceutical Sciences, , San Diego, CA, USA Health Economics Resource Center, Palo Alto Veterans Affairs HealthCare System, Palo Alto, CA, USA Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA Department of Medicine, University of Minnesota, Minneapolis, MN, USA Centers of Excellence in Substance Addiction Treatment and Education, Puget Sound VAHCS, Seattle, WA & Philadelphia VAHCS, Philadelphia, PA, USABackground Barriers at the system, clinician, and patient level limit access to medications for opioid use disorder (MOUD). The Advancing Pharmacological Treatments for Opioid Use Disorder (ADaPT-OUD) study implemented an external facilitation strategy within the Veterans Health Administration (VHA) aimed at facility-level barriers to improve uptake of MOUD. During ADaPT-OUD, an independent Academic Detailing Services Opioid Agonist Treatment of OUD Campaign was co-occurring and aimed to increase evidence-based practice for OUD at the clinician level. While both these initiatives aim to increase MOUD reach, they address different barriers and did not intentionally collaborate. Thus, understanding the interaction between these two independent implementation initiatives and their effect on MOUD reach will further inform and mold future implementation efforts of MOUD. Methods This was a secondary analysis of the ADaPT-OUD study that included 35 VHA facilities in the lowest quartile of MOUD reach; eight received the ADaPT-OUD external facilitation and 27 matched sites received implementation as usual. The number of academic detailing (AD) visits during ADaPT-OUD was used as a proxy for the intensity of Academic Detailing for OUD Campaign activity. The interaction between external facilitation status and AD intensity was evaluated by comparing the change in facility-level MOUD reach. Results There was a general increase in the number of AD visits, in both external facilitation and implementation as usual sites, over the course of ADaPT-OUD's implementation period. A non-statistically significant, positively sloped, linear relationship was observed between average number of AD visits per quarter and change in MOUD reach in facilities also receiving ADaPT-OUD external facilitation that was not observed in the implementation as usual sites. Conclusion Co-occurring initiatives focusing on different barriers to MOUD access have the potential to further increase MOUD in low-performing facilities, but further research into timing, quality, and collaboration between initiatives are warranted.https://doi.org/10.1177/26334895231199463 |
| spellingShingle | Wendy A. Miller Adam J. Gordon Barbara A. Clothier Princess E. Ackland Mark Bounthavong Carla Garcia Marie E. Kenny Siamak Noorbaloochi Hildi J. Hagedorn Co-occurring implementation strategies: The effects of academic detailing for opioid use disorder campaign on the advancing pharmacological treatments for opioid use disorder (ADaPT-OUD) study Implementation Research and Practice |
| title | Co-occurring implementation strategies: The effects of academic detailing for opioid use disorder campaign on the advancing pharmacological treatments for opioid use disorder (ADaPT-OUD) study |
| title_full | Co-occurring implementation strategies: The effects of academic detailing for opioid use disorder campaign on the advancing pharmacological treatments for opioid use disorder (ADaPT-OUD) study |
| title_fullStr | Co-occurring implementation strategies: The effects of academic detailing for opioid use disorder campaign on the advancing pharmacological treatments for opioid use disorder (ADaPT-OUD) study |
| title_full_unstemmed | Co-occurring implementation strategies: The effects of academic detailing for opioid use disorder campaign on the advancing pharmacological treatments for opioid use disorder (ADaPT-OUD) study |
| title_short | Co-occurring implementation strategies: The effects of academic detailing for opioid use disorder campaign on the advancing pharmacological treatments for opioid use disorder (ADaPT-OUD) study |
| title_sort | co occurring implementation strategies the effects of academic detailing for opioid use disorder campaign on the advancing pharmacological treatments for opioid use disorder adapt oud study |
| url | https://doi.org/10.1177/26334895231199463 |
| work_keys_str_mv | AT wendyamiller cooccurringimplementationstrategiestheeffectsofacademicdetailingforopioidusedisordercampaignontheadvancingpharmacologicaltreatmentsforopioidusedisorderadaptoudstudy AT adamjgordon cooccurringimplementationstrategiestheeffectsofacademicdetailingforopioidusedisordercampaignontheadvancingpharmacologicaltreatmentsforopioidusedisorderadaptoudstudy AT barbaraaclothier cooccurringimplementationstrategiestheeffectsofacademicdetailingforopioidusedisordercampaignontheadvancingpharmacologicaltreatmentsforopioidusedisorderadaptoudstudy AT princesseackland cooccurringimplementationstrategiestheeffectsofacademicdetailingforopioidusedisordercampaignontheadvancingpharmacologicaltreatmentsforopioidusedisorderadaptoudstudy AT markbounthavong cooccurringimplementationstrategiestheeffectsofacademicdetailingforopioidusedisordercampaignontheadvancingpharmacologicaltreatmentsforopioidusedisorderadaptoudstudy AT carlagarcia cooccurringimplementationstrategiestheeffectsofacademicdetailingforopioidusedisordercampaignontheadvancingpharmacologicaltreatmentsforopioidusedisorderadaptoudstudy AT marieekenny cooccurringimplementationstrategiestheeffectsofacademicdetailingforopioidusedisordercampaignontheadvancingpharmacologicaltreatmentsforopioidusedisorderadaptoudstudy AT siamaknoorbaloochi cooccurringimplementationstrategiestheeffectsofacademicdetailingforopioidusedisordercampaignontheadvancingpharmacologicaltreatmentsforopioidusedisorderadaptoudstudy AT hildijhagedorn cooccurringimplementationstrategiestheeffectsofacademicdetailingforopioidusedisordercampaignontheadvancingpharmacologicaltreatmentsforopioidusedisorderadaptoudstudy |