Coaching for Performance Improvement in Opioid Use Disorder

No longer recruiting at 3 trial locations
MO
CN
Overseen ByCharles Neighbors, PhD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: NYU Langone Health
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to help addiction treatment clinics enhance care for individuals with opioid use disorder. It will test a new approach, called metrics-driven quality improvement (MDQI), which includes training staff to use data effectively, focusing on patient-centered care, and employing digital tools to track patient progress. The goal is to enable clinics to use medications more effectively, retain patients in treatment longer, and support more individuals in achieving recovery. Clinics in the New York area with at least 50 clients per year, along with all their staff and patients, are ideal participants. As an unphased trial, this study offers patients the chance to contribute to innovative improvements in addiction treatment practices.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on improving treatment in clinics, so it's best to ask the trial organizers for more details.

What prior data suggests that this facilitation model is safe for addictions treatment clinics?

Research has shown that the metrics-driven quality improvement (MDQI) approach helps addiction clinics use medicines for opioid use disorder (OUD) more effectively and improve patient care. Studies have found that these strategies can increase the use of medications for OUD and help patients remain in treatment longer. This approach enhances current treatment methods rather than introducing new, untested medications.

Since this approach targets clinic processes instead of direct patient treatments, participants face no major safety concerns. The MDQI intervention involves training, guidance, and electronic tools to make care more patient-centered and effective. It focuses on improving clinic operations, which generally poses minimal risk to individuals.

Overall, evidence suggests that the MDQI intervention is safe for participants. It supports clinics and improves patient outcomes without introducing direct medical risks.12345

Why are researchers excited about this trial?

Researchers are excited about metrics-driven quality improvement (MDQI) for opioid use disorder because it offers a fresh approach to enhancing treatment outcomes by focusing on performance improvement. Unlike traditional treatments that primarily rely on medication like methadone or buprenorphine, MDQI emphasizes systematic evaluation and enhancement of care practices, which could lead to more personalized and effective treatment strategies. This approach could transform how healthcare providers address opioid use disorder by continuously refining their methods based on data-driven insights, potentially leading to better patient results and more efficient use of resources.

What evidence suggests that the metrics-driven quality improvement intervention is effective for opioid use disorder?

This trial will compare a Metrics-driven quality improvement (MDQI) intervention with a control group. Research has shown that data and coaching can enhance addiction treatment. For instance, studies have found that medications like buprenorphine reduce the risk of death by 66% to 80% in patients with opioid use disorder (OUD). The MDQI approach aims to help clinics improve care by increasing the use of these effective treatments. It emphasizes personalized care and tracks patient progress with electronic tools. These strategies aim to retain patients in treatment longer, potentially leading to better recovery outcomes.26789

Who Is on the Research Team?

CN

Charles Neighbors, PhD

Principal Investigator

NYU Langone Health

Are You a Good Fit for This Trial?

This trial is for substance use disorder clinics near New York City and the Capital Region with at least 50 clients yearly. It includes staff and patients on Medicaid, not co-insured with Medicare, from these clinics. Clinics with fewer than 50 annual clients are excluded.

Inclusion Criteria

I am enrolled in Medicaid and do not have Medicare coverage.
Substance use disorder clinics in the regions surrounding New York City and the New York Capital Region with annual census of 50 or greater
All staff and patients from participating clinics will be eligible to participate in the study

Exclusion Criteria

Patients who are not working/being treated at substance use disorder clinics with less than 50 clients per year

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Clinics receive training on data-driven management, patient-centered care, and use of electronic tools for shared decision making and patient progress monitoring

1 year

Follow-up

Participants are monitored for changes in health status, retention in care, and other secondary outcomes

1 year

What Are the Treatments Tested in This Trial?

Interventions

  • Metrics-driven quality improvement (MDQI)
Trial Overview The study tests a clinic-level intervention called Metrics-driven quality improvement (MDQI). It involves training in data management, patient-centered care for opioid disorders, and electronic tools for decision making and monitoring patient progress.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Metrics-driven quality improvement (MDQI) interventionExperimental Treatment1 Intervention
Group II: ControlActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

NYU Langone Health

Lead Sponsor

Trials
1,431
Recruited
838,000+

New York State Office of Addiction Services and Supports

Collaborator

Trials
1
Recruited
8,000+

UConn Health

Collaborator

Trials
218
Recruited
59,100+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials
2,658
Recruited
3,409,000+

Published Research Related to This Trial

The Massachusetts initiative successfully expanded the Office-Based Opioid Treatment with buprenorphine (OBOT-B) model to 14 community health centers, increasing the number of physicians authorized to prescribe buprenorphine by 375% over three years.
This collaborative care model, which emphasizes the role of nurses alongside physicians, effectively improved access to treatment for opioid use disorders, leading to a significant rise in patient admissions to these health centers.
Office-Based Opioid Treatment with Buprenorphine (OBOT-B): Statewide Implementation of the Massachusetts Collaborative Care Model in Community Health Centers.LaBelle, CT., Han, SC., Bergeron, A., et al.[2018]
The integration of recovery coaches in outpatient substance use disorder (SUD) treatment led to a 44% reduction in hospitalizations and a 9% decrease in emergency department visits among 1171 patients over six months.
Patients who initiated buprenorphine treatment and had contact with recovery coaches showed nearly double the odds of engaging in treatment and a 32% increase in opioid abstinence, highlighting the effectiveness of recovery coaches in supporting SUD management.
Peer recovery coaches in general medical settings: Changes in utilization, treatment engagement, and opioid use.Magidson, JF., Regan, S., Powell, E., et al.[2021]

Citations

Patient-centered quality measurement for opioid use disorderQuality measurement holds great promise to increase access to evidence-based, individualized OUD treatment by ensuring that providers and health systems are ...
Coaching for Performance Improvement in Opioid Use ...Metrics-driven quality improvement (MDQI) is unique because it focuses on using data and coaching to enhance the quality of care provided by addiction treatment ...
Performance Measurement for Opioid Use Disorder ...While patients with OUD are receiving medication for OUD (MOUD), most commonly buprenorphine (8, 9), their risk of death declines by 66%–80% (10, 11). MOUD is ...
States Should Measure Opioid Use Disorder Treatment to ...Studies have shown that long-term treatment can lead to better outcomes in employment, health, and criminal justice involvement.28 In addition, ...
Development and validation of a claim-based provider ...Measuring the percentage of a provider's patients with an opioid use disorder (OUD) who receive MOUD may drive quality improvement and stimulate greater use of ...
Coaching Performance Driven Practice Change in the ...This project will develop and test quality measures for and a facilitation model to help addictions treatment clinics increase use of medicines for opioid ...
A facilitation model for implementing quality improvement ...The purpose of this study is to test a multicomponent clinic-level intervention designed to aid substance use disorder treatment clinics in implementing ...
Engaging healthcare teams to increase access ...We found that the probability of patients with OUD receiving MOUD treatment improved significantly over time (16 percentage points over 7 years) ...
Harm Reduction for Opioid Use Disorder: Strategies and ...Strategies designed to reduce opioid-related harms include syringe exchange programs, overdose education and naloxone distribution, supervised consumption ...
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