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Outcomes from the medication assisted treatment pilot program for adults with opioid use disorders in rural Colorado

BACKGROUND: As Colorado ranked among the top nationally in non-medical use of opioids, a pilot medication for opioid use disorder (MOUD) program was developed to increase the number of NPs and PAs providing MOUD in order to bring this evidence- based treatment to 2 counties showing disproportionally...

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Autores principales: Amura, Claudia R., Sorrell, Tanya R., Weber, Mary, Alvarez, Andrea, Beste, Nancy, Hollins, Ursula, Cook, Paul F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722086/
https://www.ncbi.nlm.nih.gov/pubmed/34980179
http://dx.doi.org/10.1186/s13011-021-00424-4
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author Amura, Claudia R.
Sorrell, Tanya R.
Weber, Mary
Alvarez, Andrea
Beste, Nancy
Hollins, Ursula
Cook, Paul F.
author_facet Amura, Claudia R.
Sorrell, Tanya R.
Weber, Mary
Alvarez, Andrea
Beste, Nancy
Hollins, Ursula
Cook, Paul F.
author_sort Amura, Claudia R.
collection PubMed
description BACKGROUND: As Colorado ranked among the top nationally in non-medical use of opioids, a pilot medication for opioid use disorder (MOUD) program was developed to increase the number of NPs and PAs providing MOUD in order to bring this evidence- based treatment to 2 counties showing disproportionally high opioid overdose deaths. Over the first 18 months, the MOUD Pilot Program led to 15 new health care providers receiving MOUD waiver training and 1005 patients receiving MOUD from the 3 participating organizations. Here we evaluate patient centered clinical and functional outcomes of the pilot MOUD program implemented in 2 rural counties severely affected by the opioid crisis. METHODS: Under state-funded law (Colorado Senate Bill 17–074), three rural agencies submitted de-identified patient-level data at baseline (N = 1005) and after 6 months of treatment (N = 190, 25%) between December 2017 and January 2020. The Addiction Severity Index, PhQ9 and GAD-7 with McNemar-Bowker, and Wilcoxon Signed Rank tests analysis were used to measure patient outcomes across after participation in the program. . RESULTS: Patients in treatment reported using less heroin (52.1% vs 20.4%), opioids (22.3% vs 11.0%), and alcohol (28.6% vs 13.1%, all P < 0.01). Patients reported improved health (53.4% vs. 68.2%, P = 0.04), less frequency of disability (8.69 vs. 6.51, P = 0.02), symptoms (29.8% vs 21.3%), pain (67.5% to 53.6), worry (45.3% vs 62.3%), anxiety (49.7% vs 23.2%), depression (54.1% vs 23.3%, all P < 0.02) after treatment. CONCLUSIONS: This study shows decreased substance use, improved physical and mental health, and reduced symptoms after 6 months of MOUD. Although more research on retention and long-term effects is needed, data shows improved health outcomes after 6 months of MOUD. Lessons learned from implementing this pilot program informed program expansion into other rural areas in need to address some of Colorado’ major public health crises. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13011-021-00424-4.
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spelling pubmed-87220862022-01-06 Outcomes from the medication assisted treatment pilot program for adults with opioid use disorders in rural Colorado Amura, Claudia R. Sorrell, Tanya R. Weber, Mary Alvarez, Andrea Beste, Nancy Hollins, Ursula Cook, Paul F. Subst Abuse Treat Prev Policy Research BACKGROUND: As Colorado ranked among the top nationally in non-medical use of opioids, a pilot medication for opioid use disorder (MOUD) program was developed to increase the number of NPs and PAs providing MOUD in order to bring this evidence- based treatment to 2 counties showing disproportionally high opioid overdose deaths. Over the first 18 months, the MOUD Pilot Program led to 15 new health care providers receiving MOUD waiver training and 1005 patients receiving MOUD from the 3 participating organizations. Here we evaluate patient centered clinical and functional outcomes of the pilot MOUD program implemented in 2 rural counties severely affected by the opioid crisis. METHODS: Under state-funded law (Colorado Senate Bill 17–074), three rural agencies submitted de-identified patient-level data at baseline (N = 1005) and after 6 months of treatment (N = 190, 25%) between December 2017 and January 2020. The Addiction Severity Index, PhQ9 and GAD-7 with McNemar-Bowker, and Wilcoxon Signed Rank tests analysis were used to measure patient outcomes across after participation in the program. . RESULTS: Patients in treatment reported using less heroin (52.1% vs 20.4%), opioids (22.3% vs 11.0%), and alcohol (28.6% vs 13.1%, all P < 0.01). Patients reported improved health (53.4% vs. 68.2%, P = 0.04), less frequency of disability (8.69 vs. 6.51, P = 0.02), symptoms (29.8% vs 21.3%), pain (67.5% to 53.6), worry (45.3% vs 62.3%), anxiety (49.7% vs 23.2%), depression (54.1% vs 23.3%, all P < 0.02) after treatment. CONCLUSIONS: This study shows decreased substance use, improved physical and mental health, and reduced symptoms after 6 months of MOUD. Although more research on retention and long-term effects is needed, data shows improved health outcomes after 6 months of MOUD. Lessons learned from implementing this pilot program informed program expansion into other rural areas in need to address some of Colorado’ major public health crises. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13011-021-00424-4. BioMed Central 2022-01-03 /pmc/articles/PMC8722086/ /pubmed/34980179 http://dx.doi.org/10.1186/s13011-021-00424-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Amura, Claudia R.
Sorrell, Tanya R.
Weber, Mary
Alvarez, Andrea
Beste, Nancy
Hollins, Ursula
Cook, Paul F.
Outcomes from the medication assisted treatment pilot program for adults with opioid use disorders in rural Colorado
title Outcomes from the medication assisted treatment pilot program for adults with opioid use disorders in rural Colorado
title_full Outcomes from the medication assisted treatment pilot program for adults with opioid use disorders in rural Colorado
title_fullStr Outcomes from the medication assisted treatment pilot program for adults with opioid use disorders in rural Colorado
title_full_unstemmed Outcomes from the medication assisted treatment pilot program for adults with opioid use disorders in rural Colorado
title_short Outcomes from the medication assisted treatment pilot program for adults with opioid use disorders in rural Colorado
title_sort outcomes from the medication assisted treatment pilot program for adults with opioid use disorders in rural colorado
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722086/
https://www.ncbi.nlm.nih.gov/pubmed/34980179
http://dx.doi.org/10.1186/s13011-021-00424-4
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