Addiction Treatment in Primary Care Expansion
NCT03547882 · Status: WITHDRAWN · Type: OBSERVATIONAL
Last updated 2024-03-25
Summary
The Veterans Health Administration (VA) is a national leader in addressing the twin epidemics of chronic pain and opioid use, misuse, and opioid use disorder (OUD); but important challenges remain. Both chronic pain and OUD are more common among Veterans compared to the general population.1 As the VA transitions toward a greater emphasis on non-opioid chronic pain treatments, improving access to OUD treatment will be critical for those Veterans with new diagnoses of OUD in the context of long-term opioid therapy. Strong evidence supports the treatment of OUD with medications, including naltrexone, buprenorphine, and methadone.2 Buprenorphine and naltrexone can be prescribed in primary care settings; OUD treatment in primary care is associated with decreased opioid use, higher quality of care, and improved quality of life.3-5 In partnership with VISN19 leadership, this project will address the priority goal of improving access to medication-assisted therapy for OUD treatment. The objective of the VISN Partnered Implementation Initiative startup phase (PHASE 1) is to implement and evaluate the evidence-based, effective practice of medication treatment of opioid use disorder in primary care settings. A subsequent PHASE 2 will study the implementation of strategies from PHASE 1 across the entire VISN19. The investigators propose two specific aims:
Aim 1: Evaluate the implementation and impact of a multifaceted provider support initiative at two VA medical centers and four community-based clinics in VISN19 using the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) implementation framework. The multifaceted initiative will leverage existing VA and VISN resources (including e-consults, telementoring and telehealth) to facilitate improved access to OUD treatment in primary care.
Aim 2: Create an interactive implementation toolkit with guidance on facilitation and incentive strategies and resources for broader dissemination across the VISN and VA.
Conditions
- Opioid Use Disorder (OUD)
- Chronic Pain
Sponsors & Collaborators
-
VA Eastern Colorado Health Care System
collaborator FED -
University of Colorado, Denver
collaborator OTHER - collaborator OTHER
-
VA Office of Research and Development
lead FED
Principal Investigators
-
Adam J. Gordon, MD MPH · VA Salt Lake City Health Care System, Salt Lake City, UT
-
Joseph W Frank, MD MPH · Rocky Mountain Regional VA Medical Center, Aurora, CO
Eligibility
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2018-05-01
- Primary Completion
- 2021-09-30
- Completion
- 2021-09-30
Countries
- United States
Study Locations
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