Design of a pragmatic clinical trial to improve screening and treatment for opioid use disorder in primary care.

Autor: Rossom RC; HealthPartners Institute, 8170 33rd Ave S, MS21112R, Minneapolis, MN, 55425, United States of America. Electronic address: Rebecca.C.Rossom@HealthPartners.com., Crain AL; HealthPartners Institute, 8170 33rd Ave S, MS21112R, Minneapolis, MN, 55425, United States of America. Electronic address: Lauren.A.Crain@HealthPartners.com., O'Connor PJ; HealthPartners Institute, 8170 33rd Ave S, MS21112R, Minneapolis, MN, 55425, United States of America. Electronic address: Patrick.J.OConnor@HealthPartners.com., Wright E; Geisinger Health, 100 North Academy Ave., Danville, PA 17822, United States of America. Electronic address: ewright2@geisinger.edu., Haller IV; Essentia Institute of Rural Health, 502 E 2nd St, Duluth, MN 55805, United States of America. Electronic address: Irina.Haller@EssentiaHealth.org., Hooker SA; HealthPartners Institute, 8170 33rd Ave S, MS21112R, Minneapolis, MN, 55425, United States of America. Electronic address: Stephanie.A.Hooker@HealthPartners.com., Sperl-Hillen JM; HealthPartners Institute, 8170 33rd Ave S, MS21112R, Minneapolis, MN, 55425, United States of America. Electronic address: JoAnn.M.SperlHillen@HealthPartners.com., Olson A; Essentia Institute of Rural Health, 502 E 2nd St, Duluth, MN 55805, United States of America. Electronic address: Anthony.Olson@EssentiaHealth.org., Romagnoli K; Geisinger Health, 100 North Academy Ave., Danville, PA 17822, United States of America. Electronic address: kmromagnoli@geisinger.edu., Solberg L; HealthPartners Institute, 8170 33rd Ave S, MS21112R, Minneapolis, MN, 55425, United States of America. Electronic address: Leif.I.Solberg@HealthPartners.com., Dehmer SP; HealthPartners Institute, 8170 33rd Ave S, MS21112R, Minneapolis, MN, 55425, United States of America. Electronic address: Steven.P.Dehmer@HealthPartners.com., Haapala J; HealthPartners Institute, 8170 33rd Ave S, MS21112R, Minneapolis, MN, 55425, United States of America. Electronic address: Jacob.L.Haapala@HealthPartners.com., Borgert-Spaniol C; HealthPartners Institute, 8170 33rd Ave S, MS21112R, Minneapolis, MN, 55425, United States of America. Electronic address: Caitlin.M.BorgertSpaniol@HealthPartners.com., Tusing L; Geisinger Health, 100 North Academy Ave., Danville, PA 17822, United States of America. Electronic address: ldtusing@geisinger.edu., Muegge J; HealthPartners Institute, 8170 33rd Ave S, MS21112R, Minneapolis, MN, 55425, United States of America. Electronic address: Jule.M.Muegge@HealthPartners.com., Allen C; Essentia Institute of Rural Health, 502 E 2nd St, Duluth, MN 55805, United States of America. Electronic address: Clayton.Allen@EssentiaHealth.org., Ekstrom H; HealthPartners Institute, 8170 33rd Ave S, MS21112R, Minneapolis, MN, 55425, United States of America. Electronic address: Heidi.L.Ekstrom@HealthPartners.com., Huntley K; National Institute on Drug Abuse, Center for the Clinical Trials Network, 16071 Industrial Dr, Gaithersburg, MD 20877, United States of America. Electronic address: kristen.huntley@nih.gov., McCormack J; The Emmes Company, 401 N Washington St # 700, Rockville, MD 20850, United States of America. Electronic address: jmccormack@emmes.com., Bart G; Hennepin Healthcare Research Institute, 825 8th St S, Minneapolis, MN 55404, United States of America. Electronic address: bartx005@umn.edu.
Jazyk: angličtina
Zdroj: Contemporary clinical trials [Contemp Clin Trials] 2023 Jan; Vol. 124, pp. 107012. Date of Electronic Publication: 2022 Nov 17.
DOI: 10.1016/j.cct.2022.107012
Abstrakt: Background: Opioid-related deaths continue to rise in the U.S. A shared decision-making (SDM) system to help primary care clinicians (PCCs) identify and treat patients with opioid use disorder (OUD) could help address this crisis.
Methods: In this cluster-randomized trial, primary care clinics in three healthcare systems were randomized to receive or not receive access to an OUD-SDM system. The OUD-SDM system alerts PCCs and patients to elevated risk of OUD and supports OUD screening and treatment. It includes guidance on OUD screening and diagnosis, treatment selection, starting and maintaining patients on buprenorphine for waivered clinicians, and screening for common comorbid conditions. The primary study outcome is, of patients at high risk for OUD, the percentage receiving an OUD diagnosis within 30 days of index visit. Additional outcomes are, of patients at high risk for or with a diagnosis of OUD, (a) the percentage receiving a naloxone prescription, or (b) the percentage receiving a medication for OUD (MOUD) prescription or referral to specialty care within 30 days of an index visit, and (c) total days covered by a MOUD prescription within 90 days of an index visit.
Results: The intervention started in April 2021 and continues through December 2023. PCCs and patients in 90 clinics are included; study results are expected in 2024.
Conclusion: This protocol paper describes the design of a multi-site trial to help PCCs recognize and treat OUD. If effective, this OUD-SDM intervention could improve screening of at-risk patients and rates of OUD treatment for people with OUD.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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