Julie G Salvador1, Snehal R Bhatt1, Vanessa C Jacobsohn1, Larissa A Maley2, Rana S Alkhafaji1, Heidi Rishel Brakey3, Orrin B Myers4, Andrew L Sussman4. 1. Department of Psychiatry and Behavioral Sciences, Health Sciences Center, University of New Mexico, Albuquerque, New Mexico, USA. 2. Addictions and Substance Abuse Program, University of New Mexico Hospital, Albuquerque, New Mexico, USA. 3. Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA. 4. Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
Abstract
Background: Buprenorphine combined with psychosocial support is the standard of care for treatment of opioid use disorder (OUD) in office-based primary care settings. However, uptake of this treatment has been slow due to a number of addressable barriers including providers' lack of training, staffing concerns, stigma and the need for ongoing support and consultation. This study examined acceptability and feasibility of an online Extensions for Community Healthcare Outcomes (ECHO) model intervention developed to support rural primary care clinics to expand treatment and is part of a larger study tracking the impact of participation in this ECHO on expansion of MOUD in rural primary care. Methods: We developed a comprehensive, 12-week online education and mentorship intervention using ECHO aimed at supporting the entire primary care clinic to start or expand treatment using MOUD, psychosocial treatments and recovery supports. We tracked participation and collected feedback using qualitative interviews and post-session questionnaires. Results: Sixty-seven primary care staff across 27 rural clinics in New Mexico participated in the study including 32 prescribers and 35 clinic support staff. Average participation was 4/12 sessions. Post-session questionnaires showed positive feedback, including that 95% or more respondents agreed or strongly agreed that the sessions were relevant and improved their confidence. Qualitative interview themes included strong endorsement of the ECHO curriculum. Clinical duties were the most common barrier to attending sessions. Conclusions: Engagement of 27 clinics, the range of staff and providers who participated, and positive feedback gathered through survey and qualitative interviews provide evidence of feasibility and acceptability of MOUD ECHO to support expansion of this treatment. However, barriers to participation present an important threat to feasibility. Understanding feasibility and acceptability is an important component of research on the impact of ECHO to expand MOUD treatment.
Background: Buprenorphine combined with psychosocial support is the standard of care for treatment of opioid use disorder (OUD) in office-based primary care settings. However, uptake of this treatment has been slow due to a number of addressable barriers including providers' lack of training, staffing concerns, stigma and the need for ongoing support and consultation. This study examined acceptability and feasibility of an online Extensions for Community Healthcare Outcomes (ECHO) model intervention developed to support rural primary care clinics to expand treatment and is part of a larger study tracking the impact of participation in this ECHO on expansion of MOUD in rural primary care. Methods: We developed a comprehensive, 12-week online education and mentorship intervention using ECHO aimed at supporting the entire primary care clinic to start or expand treatment using MOUD, psychosocial treatments and recovery supports. We tracked participation and collected feedback using qualitative interviews and post-session questionnaires. Results: Sixty-seven primary care staff across 27 rural clinics in New Mexico participated in the study including 32 prescribers and 35 clinic support staff. Average participation was 4/12 sessions. Post-session questionnaires showed positive feedback, including that 95% or more respondents agreed or strongly agreed that the sessions were relevant and improved their confidence. Qualitative interview themes included strong endorsement of the ECHO curriculum. Clinical duties were the most common barrier to attending sessions. Conclusions: Engagement of 27 clinics, the range of staff and providers who participated, and positive feedback gathered through survey and qualitative interviews provide evidence of feasibility and acceptability of MOUD ECHO to support expansion of this treatment. However, barriers to participation present an important threat to feasibility. Understanding feasibility and acceptability is an important component of research on the impact of ECHO to expand MOUD treatment.
Entities:
Keywords:
ECHO model; Implementation science; medications for treatment of opioid use disorder; primary care; rural
Authors: Andrew Kolodny; David T Courtwright; Catherine S Hwang; Peter Kreiner; John L Eadie; Thomas W Clark; G Caleb Alexander Journal: Annu Rev Public Health Date: 2015-01-12 Impact factor: 21.981
Authors: Andrew Rosenblum; Charles M Cleland; Chunki Fong; Deborah J Kayman; Barbara Tempalski; Mark Parrino Journal: J Environ Public Health Date: 2011-07-06
Authors: Gerald Cochran; Evan S Cole; Jack Warwick; Julie M Donohue; Adam J Gordon; Walid F Gellad; Todd Bear; David Kelley; Ellen DiDomenico; Jan Pringle Journal: Addict Sci Clin Pract Date: 2019-08-01
Authors: Emmeline N Taylor; Christine Timko; Ingrid A Binswanger; Alex H S Harris; Matthew Stimmel; David Smelson; Andrea K Finlay Journal: Subst Abus Date: 2021-09-29 Impact factor: 3.984