Strategies to recruit rural primary care providers to implement a medication for opioid use disorder (MOUD) focused integrated care model.

Autor:	Cloutier RM; Program Evaluation and Research Unit, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA., Cole ES; Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA., McDonough BL; Program Evaluation and Research Unit, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA., Lomauro DA; Program Evaluation and Research Unit, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA., Miller JP; Program Evaluation and Research Unit, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA., Talbert AL; Program Evaluation and Research Unit, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA., Bear TM; Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA., Bridges NC; Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA., Foulds AL; Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA., Taber R; Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA., Gordon AJ; Program for Addiction Research, Clinical Care, Education, and Advocacy, University of Utah School of Medicine, Salt Lake City, UT, USA., Cochran GT; Program for Addiction Research, Clinical Care, Education, and Advocacy, University of Utah School of Medicine, Salt Lake City, UT, USA., Kmiec J; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA., Donohue JM; Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA., Kelley D; Office of Medical Assistance Programs, Pennsylvania Department of Human Services, Harrisburg, PA, USA., DiDomenico E; Pennsylvania Department of Drug and Alcohol Programs, Harrisburg, PA, USA., Adair D; Office of Medical Assistance Programs, Pennsylvania Department of Human Services, Harrisburg, PA, USA., Pringle JL; Program Evaluation and Research Unit, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA.
Jazyk:	angličtina
Zdroj:	Implementation research and practice [Implement Res Pract] 2023 Feb 19; Vol. 4, pp. 26334895231152808. Date of Electronic Publication: 2023 Feb 19 (Print Publication: 2023).
DOI:	10.1177/26334895231152808
Abstrakt:	Background: Access to providers and programs that provide medications for opioid use disorder (MOUD) remains a systemic barrier for patients with opioid use disorder (OUD), particularly if they live in rural areas. The Rural Access to Medication Assisted Treatment (MAT) in Pennsylvania Project (Project RAMP) addressed this problem with a multisystem partnership that recruited, trained, and supported rural primary care providers to provide MOUD and implement an integrated care model (ICM) for patients with OUD. Given the demonstrated efficacy of Project RAMP, this article summarizes our recruitment strategies, including feasibility concerns for further expansion into other regions. Methods: The approach for recruiting implementation sites included two phases: partner outreach and site identification. Once recruited, the Systems Transformation Framework guided planning and implementation activities. Recruitment and implementation activities were assessed with implementation trackers and evaluated by providers via key informant interviews (KIIs). Results: Project RAMP recruited 26 primary care practices from 13 counties, including nine health systems and two private practice groups-exceeding the original target of 24 sites. There was a median of 49 days from first contact to project onboarding. A total of 108 primary care practices spanning 22 health systems declined participation. Findings from the KIIs highlighted the value of engaging PCPs by connecting to a shared vision (i.e., improving the quality of patient care) as well as addressing perceived participation barriers (e.g., offering concierge technical assistance to address lack of training or resources). Conclusion: Findings highlight how successful recruitment activities should leverage the support of health system leadership. Findings also emphasize that aiding recruitment and engagement efforts successfully addressed prescribers' perceived barriers to providing MOUD as well as facilitating better communication among administrators, PCPs, behavioral health professionals, care managers, and patients. Plain Language Summary: Opioid use disorder (OUD) is one of the leading causes of preventable illness and death. The standard of care for OUD is the provision of medications for opioid use disorder (MOUD) and the application of an integrative integrated care model (ICM) where behavioral health is blended with specialized medical services. Unfortunately, access to providers and healthcare facilities that provide MOUD or apply an ICM remains a systemic barrier for patients with OUD, particularly if they live in rural areas. Although there is no one-size-fits-all approach to implementing MOUD in primary care, findings from Project The Rural Access to Medication Assisted Treatment (MAT) in Pennsylvania Project (Project RAMP) highlight strategies that may improve future MOUD and ICM implementation efforts in similar rural contexts. Specifically, future efforts to increase MOUD capacity by recruiting new providers should be prepared to leverage health system leadership, address provider barriers via training and expert consultation, and facilitate connections to local behavioral health providers. This approach may be helpful to others recruiting health systems and primary care practices to implement new care models to use MOUD in treating patients with OUD. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2023.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu