Test of a workforce development intervention to expand opioid use disorder treatment pharmacotherapy prescribers: protocol for a cluster randomized trial
Abstract Background Overdoses due to non-medical use of prescription opioids and other opiates have become the leading cause of accidental deaths in the USA. Buprenorphine and extended-release naltrexone are key evidence-based pharmacotherapies available to addiction treatment providers to address o...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-11-01
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| Series: | Implementation Science |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13012-017-0665-x |
| _version_ | 1818501525602828288 |
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| author | Todd Molfenter Hannah K. Knudsen Randy Brown Nora Jacobson Julie Horst Mark Van Etten Jee-Seon Kim Eric Haram Elizabeth Collier Sanford Starr Alexander Toy Lynn Madden |
| author_facet | Todd Molfenter Hannah K. Knudsen Randy Brown Nora Jacobson Julie Horst Mark Van Etten Jee-Seon Kim Eric Haram Elizabeth Collier Sanford Starr Alexander Toy Lynn Madden |
| author_sort | Todd Molfenter |
| collection | DOAJ |
| description | Abstract Background Overdoses due to non-medical use of prescription opioids and other opiates have become the leading cause of accidental deaths in the USA. Buprenorphine and extended-release naltrexone are key evidence-based pharmacotherapies available to addiction treatment providers to address opioid use disorder (OUD) and prevent overdose deaths. Treatment organizations’ efforts to provide these pharmacotherapies have, however, been stymied by limited success in recruiting providers (physicians, nurse practitioners, and physician assistants) to prescribe these medications. Historically, the addiction treatment field has not attracted physicians, and many barriers to implementing OUD pharmacotherapy exist, ranging from lack of confidence in treating OUD patients to concerns regarding reimbursement. Throughout the USA, the prevalence of OUD far exceeds the capacity of the OUD pharmacotherapy treatment system. Poor access to OUD pharmacotherapy prescribers has become a workforce development need for the addiction treatment field and a significant health issue. Methods This cluster randomized controlled trial (RCT) is designed to increase buprenorphine and extended-release naltrexone treatment capacity for OUD. The implementation intervention to be tested is a bundle of OUD pharmacotherapy capacity building practices called the Prescriber Recruitment Bundle (PRB), which was developed and piloted in a previous statewide buprenorphine implementation study. For this cluster RCT, organizational sites will be recruited and then randomized into one of two arms: (1) control, with treatment as usual and access to a website with PRB resources, or (2) intervention, with organizations implementing the PRB using the Network for the Improvement of Addiction Treatment organizational change model over a 24-month intervention period and a 10-month sustainability period. The primary treatment outcomes for each organizational site are self-reported monthly counts of buprenorphine slots, extended-release naltrexone capacity, number of buprenorphine patients, and number of extended-release naltrexone patients. This trial will be conducted in Florida, Ohio, and Wisconsin, resulting in 35 sites in each arm, for a total sample size of 70 organizations. Discussion This study addresses three issues of substantial public health significance: (1) the pressing opioid misuse epidemic, (2) the low uptake of OUD treatment pharmacotherapies, and (3) the need to increase prescriber participation in the addiction treatment workforce. Trial registration ClinicalTrials.gov NCT02926482 , |
| first_indexed | 2024-12-10T20:57:25Z |
| format | Article |
| id | doaj.art-fcf89baa279444ba86a2646f72dadccb |
| institution | Directory Open Access Journal |
| issn | 1748-5908 |
| language | English |
| last_indexed | 2024-12-10T20:57:25Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science |
| spelling | doaj.art-fcf89baa279444ba86a2646f72dadccb2022-12-22T01:33:56ZengBMCImplementation Science1748-59082017-11-011211910.1186/s13012-017-0665-xTest of a workforce development intervention to expand opioid use disorder treatment pharmacotherapy prescribers: protocol for a cluster randomized trialTodd Molfenter0Hannah K. Knudsen1Randy Brown2Nora Jacobson3Julie Horst4Mark Van Etten5Jee-Seon KimEric Haram6Elizabeth CollierSanford StarrAlexander Toy7Lynn Madden8Department of Industrial and Systems Engineering, University of Wisconsin-MadisonDepartment of Behavioral Science and Center on Drug and Alcohol Research, University of KentuckyDepartment of Family Medicine and Community Health, University of Wisconsin-MadisonInstitute for Clinical and Translational Research, University of Wisconsin-MadisonDepartment of Industrial and Systems Engineering, University of Wisconsin-MadisonDepartment of Industrial and Systems Engineering, University of Wisconsin-MadisonDepartment of Industrial and Systems Engineering, University of Wisconsin-MadisonDepartment of Industrial and Systems Engineering, University of Wisconsin-MadisonDepartment of Industrial and Systems Engineering, University of Wisconsin-MadisonAbstract Background Overdoses due to non-medical use of prescription opioids and other opiates have become the leading cause of accidental deaths in the USA. Buprenorphine and extended-release naltrexone are key evidence-based pharmacotherapies available to addiction treatment providers to address opioid use disorder (OUD) and prevent overdose deaths. Treatment organizations’ efforts to provide these pharmacotherapies have, however, been stymied by limited success in recruiting providers (physicians, nurse practitioners, and physician assistants) to prescribe these medications. Historically, the addiction treatment field has not attracted physicians, and many barriers to implementing OUD pharmacotherapy exist, ranging from lack of confidence in treating OUD patients to concerns regarding reimbursement. Throughout the USA, the prevalence of OUD far exceeds the capacity of the OUD pharmacotherapy treatment system. Poor access to OUD pharmacotherapy prescribers has become a workforce development need for the addiction treatment field and a significant health issue. Methods This cluster randomized controlled trial (RCT) is designed to increase buprenorphine and extended-release naltrexone treatment capacity for OUD. The implementation intervention to be tested is a bundle of OUD pharmacotherapy capacity building practices called the Prescriber Recruitment Bundle (PRB), which was developed and piloted in a previous statewide buprenorphine implementation study. For this cluster RCT, organizational sites will be recruited and then randomized into one of two arms: (1) control, with treatment as usual and access to a website with PRB resources, or (2) intervention, with organizations implementing the PRB using the Network for the Improvement of Addiction Treatment organizational change model over a 24-month intervention period and a 10-month sustainability period. The primary treatment outcomes for each organizational site are self-reported monthly counts of buprenorphine slots, extended-release naltrexone capacity, number of buprenorphine patients, and number of extended-release naltrexone patients. This trial will be conducted in Florida, Ohio, and Wisconsin, resulting in 35 sites in each arm, for a total sample size of 70 organizations. Discussion This study addresses three issues of substantial public health significance: (1) the pressing opioid misuse epidemic, (2) the low uptake of OUD treatment pharmacotherapies, and (3) the need to increase prescriber participation in the addiction treatment workforce. Trial registration ClinicalTrials.gov NCT02926482 ,http://link.springer.com/article/10.1186/s13012-017-0665-xEvidence-based practice implementationMedication-Assisted TreatmentBuprenorphineNaltrexoneAddiction treatment |
| spellingShingle | Todd Molfenter Hannah K. Knudsen Randy Brown Nora Jacobson Julie Horst Mark Van Etten Jee-Seon Kim Eric Haram Elizabeth Collier Sanford Starr Alexander Toy Lynn Madden Test of a workforce development intervention to expand opioid use disorder treatment pharmacotherapy prescribers: protocol for a cluster randomized trial Implementation Science Evidence-based practice implementation Medication-Assisted Treatment Buprenorphine Naltrexone Addiction treatment |
| title | Test of a workforce development intervention to expand opioid use disorder treatment pharmacotherapy prescribers: protocol for a cluster randomized trial |
| title_full | Test of a workforce development intervention to expand opioid use disorder treatment pharmacotherapy prescribers: protocol for a cluster randomized trial |
| title_fullStr | Test of a workforce development intervention to expand opioid use disorder treatment pharmacotherapy prescribers: protocol for a cluster randomized trial |
| title_full_unstemmed | Test of a workforce development intervention to expand opioid use disorder treatment pharmacotherapy prescribers: protocol for a cluster randomized trial |
| title_short | Test of a workforce development intervention to expand opioid use disorder treatment pharmacotherapy prescribers: protocol for a cluster randomized trial |
| title_sort | test of a workforce development intervention to expand opioid use disorder treatment pharmacotherapy prescribers protocol for a cluster randomized trial |
| topic | Evidence-based practice implementation Medication-Assisted Treatment Buprenorphine Naltrexone Addiction treatment |
| url | http://link.springer.com/article/10.1186/s13012-017-0665-x |
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