| Title: |
Nurse Care Management for Opioid Use Disorder Treatment: The PROUD Cluster Randomized Clinical Trial |
| Authors: |
Wartko, Paige D; Bobb, Jennifer F; Boudreau, Denise M; Matthews, Abigail G; McCormack, Jennifer; Lee, Amy K; Qiu, Hongxiang; Yu, Onchee; Hyun, Noorie; Idu, Abisola E; Campbell, Cynthia I; Saxon, Andrew J; Liu, David S; Altschuler, Andrea; Samet, Jeffrey H; Labelle, Colleen T; Zare-Mehrjerdi, Mohammad; Stotts, Angela L; Braciszewski, Jordan M; Murphy, Mark T; Dryden, Douglas; Arnsten, Julia H; Cunningham, Chinazo O; Horigian, Viviana E; Szapocznik, José; Glass, Joseph E; Caldeiro, Ryan M; Phillips, Rebecca C; Shea, Mary; Bart, Gavin; Schwartz, Robert P; McNeely, Jennifer; Liebschutz, Jane M; Tsui, Judith I; Merrill, Joseph O; Lapham, Gwen T; Addis, Megan; Bradley, Katharine A; Ghiroli, Megan M; Hamilton, Leah K; Hu, Yong; LaHue, Jennifer S; Loree, Amy M.; Murphy, Sean M; Northrup, Thomas F; Shmueli-Blumberg, Dikla; Silva, Angela J; Weinstein, Zoe M; Wong, Mark TinFook; Burganowski, Rachael P |
| Source: |
Center for Health Policy and Health Services Research Articles |
| Publisher Information: |
Henry Ford Health Scholarly Commons |
| Publication Year: |
2023 |
| Collection: |
Henry Ford Health System Scholarly Commons |
| Subject Terms: |
Humans; Female; Middle Aged; Adolescent; Young Adult; Adult; Aged; 80 and over; Male; Naltrexone; Opiate Substitution Treatment; Leadership; Opioid-Related Disorders; Buprenorphine |
| Description: |
IMPORTANCE: Few primary care (PC) practices treat patients with medications for opioid use disorder (OUD) despite availability of effective treatments. OBJECTIVE: To assess whether implementation of the Massachusetts model of nurse care management for OUD in PC increases OUD treatment with buprenorphine or extended-release injectable naltrexone and secondarily decreases acute care utilization. DESIGN, SETTING, AND PARTICIPANTS: The Primary Care Opioid Use Disorders Treatment (PROUD) trial was a mixed-methods, implementation-effectiveness cluster randomized clinical trial conducted in 6 diverse health systems across 5 US states (New York, Florida, Michigan, Texas, and Washington). Two PC clinics in each system were randomized to intervention or usual care (UC) stratified by system (5 systems were notified on February 28, 2018, and 1 system with delayed data use agreement on August 31, 2018). Data were obtained from electronic health records and insurance claims. An implementation monitoring team collected qualitative data. Primary care patients were included if they were 16 to 90 years old and visited a participating clinic from up to 3 years before a system's randomization date through 2 years after. INTERVENTION: The PROUD intervention included 3 components: (1) salary for a full-time OUD nurse care manager; (2) training and technical assistance for nurse care managers; and (3) 3 or more PC clinicians agreeing to prescribe buprenorphine. MAIN OUTCOMES AND MEASURES: The primary outcome was a clinic-level measure of patient-years of OUD treatment (buprenorphine or extended-release injectable naltrexone) per 10 000 PC patients during the 2 years postrandomization (follow-up). The secondary outcome, among patients with OUD prerandomization, was a patient-level measure of the number of days of acute care utilization during follow-up. RESULTS: During the baseline period, a total of 130 623 patients were seen in intervention clinics (mean [SD] age, 48.6 [17.7] years; 59.7% female), and 159 459 patients were seen in UC ... |
| Document Type: |
text |
| Language: |
unknown |
| Relation: |
https://scholarlycommons.henryford.com/chphsr_articles/329; http://sfxhosted.exlibrisgroup.com/hfhs?sid=Entrez:PubMed&id=pmid:37902748 |
| Availability: |
https://scholarlycommons.henryford.com/chphsr_articles/329; http://sfxhosted.exlibrisgroup.com/hfhs?sid=Entrez:PubMed&id=pmid:37902748 |
| Accession Number: |
edsbas.7CCFCDFD |
| Database: |
BASE |