Cargando…

Sustaining alcohol and opioid use disorder treatment in primary care: a mixed methods study

BACKGROUND: Efforts to integrate substance use disorder treatment into primary care settings are growing. Little is known about how well primary care settings can sustain treatment delivery to address substance use following the end of implementation support. METHODS: Data from two clinics operated...

Descripción completa

Detalles Bibliográficos
Autores principales: Hunter, Sarah B., Ober, Allison J., McCullough, Colleen M., Storholm, Erik D., Iyiewuare, Praise O., Pham, Chau, Watkins, Katherine E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006923/
https://www.ncbi.nlm.nih.gov/pubmed/29914524
http://dx.doi.org/10.1186/s13012-018-0777-y
_version_ 1783332942234255360
author Hunter, Sarah B.
Ober, Allison J.
McCullough, Colleen M.
Storholm, Erik D.
Iyiewuare, Praise O.
Pham, Chau
Watkins, Katherine E.
author_facet Hunter, Sarah B.
Ober, Allison J.
McCullough, Colleen M.
Storholm, Erik D.
Iyiewuare, Praise O.
Pham, Chau
Watkins, Katherine E.
author_sort Hunter, Sarah B.
collection PubMed
description BACKGROUND: Efforts to integrate substance use disorder treatment into primary care settings are growing. Little is known about how well primary care settings can sustain treatment delivery to address substance use following the end of implementation support. METHODS: Data from two clinics operated by one multi-site federally qualified health center (FQHC) in the US, including administrative data, staff surveys, interviews, and focus groups, were used to gather information about changes in organizational capacity related to alcohol and opioid use disorder (AOUD) treatment delivery during and after a multi-year implementation intervention was executed. Treatment practices from the intervention period were compared to practices after the intervention period to examine whether the practices were sustained. Data from staff surveys and interviews were used to examine the factors related to sustainment. RESULTS: The two clinics sustained multiple components of AOUD care 1 year following the end of implementation support, including care coordination, psychotherapy, and medication-assisted treatment. Some of the practices were modified over time, for example, screening became less frequent by design, while use of care coordination and psychotherapy for AOUDs expanded. Participants identified staff training and funding for medications as key challenges to sustaining treatment. CONCLUSIONS: Following a multi-year implementation intervention, a large FQHC continued to deliver AOUD treatment. Access to external funding and staff support appeared to be critical elements for sustaining care over time. TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT01810159
format Online
Article
Text
id pubmed-6006923
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-60069232018-06-26 Sustaining alcohol and opioid use disorder treatment in primary care: a mixed methods study Hunter, Sarah B. Ober, Allison J. McCullough, Colleen M. Storholm, Erik D. Iyiewuare, Praise O. Pham, Chau Watkins, Katherine E. Implement Sci Research BACKGROUND: Efforts to integrate substance use disorder treatment into primary care settings are growing. Little is known about how well primary care settings can sustain treatment delivery to address substance use following the end of implementation support. METHODS: Data from two clinics operated by one multi-site federally qualified health center (FQHC) in the US, including administrative data, staff surveys, interviews, and focus groups, were used to gather information about changes in organizational capacity related to alcohol and opioid use disorder (AOUD) treatment delivery during and after a multi-year implementation intervention was executed. Treatment practices from the intervention period were compared to practices after the intervention period to examine whether the practices were sustained. Data from staff surveys and interviews were used to examine the factors related to sustainment. RESULTS: The two clinics sustained multiple components of AOUD care 1 year following the end of implementation support, including care coordination, psychotherapy, and medication-assisted treatment. Some of the practices were modified over time, for example, screening became less frequent by design, while use of care coordination and psychotherapy for AOUDs expanded. Participants identified staff training and funding for medications as key challenges to sustaining treatment. CONCLUSIONS: Following a multi-year implementation intervention, a large FQHC continued to deliver AOUD treatment. Access to external funding and staff support appeared to be critical elements for sustaining care over time. TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT01810159 BioMed Central 2018-06-18 /pmc/articles/PMC6006923/ /pubmed/29914524 http://dx.doi.org/10.1186/s13012-018-0777-y Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Hunter, Sarah B.
Ober, Allison J.
McCullough, Colleen M.
Storholm, Erik D.
Iyiewuare, Praise O.
Pham, Chau
Watkins, Katherine E.
Sustaining alcohol and opioid use disorder treatment in primary care: a mixed methods study
title Sustaining alcohol and opioid use disorder treatment in primary care: a mixed methods study
title_full Sustaining alcohol and opioid use disorder treatment in primary care: a mixed methods study
title_fullStr Sustaining alcohol and opioid use disorder treatment in primary care: a mixed methods study
title_full_unstemmed Sustaining alcohol and opioid use disorder treatment in primary care: a mixed methods study
title_short Sustaining alcohol and opioid use disorder treatment in primary care: a mixed methods study
title_sort sustaining alcohol and opioid use disorder treatment in primary care: a mixed methods study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006923/
https://www.ncbi.nlm.nih.gov/pubmed/29914524
http://dx.doi.org/10.1186/s13012-018-0777-y
work_keys_str_mv AT huntersarahb sustainingalcoholandopioidusedisordertreatmentinprimarycareamixedmethodsstudy
AT oberallisonj sustainingalcoholandopioidusedisordertreatmentinprimarycareamixedmethodsstudy
AT mcculloughcolleenm sustainingalcoholandopioidusedisordertreatmentinprimarycareamixedmethodsstudy
AT storholmerikd sustainingalcoholandopioidusedisordertreatmentinprimarycareamixedmethodsstudy
AT iyiewuarepraiseo sustainingalcoholandopioidusedisordertreatmentinprimarycareamixedmethodsstudy
AT phamchau sustainingalcoholandopioidusedisordertreatmentinprimarycareamixedmethodsstudy
AT watkinskatherinee sustainingalcoholandopioidusedisordertreatmentinprimarycareamixedmethodsstudy