Implementation Facilitation for Alcohol Use Disorder

Overseen By Melanie Bennett, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Maryland, Baltimore

Disqualifiers: Under 18, Unable to consent

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

40 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate how effectively a new support program, called External Facilitation, assists doctors in prescribing medication for individuals with alcohol use disorder. The program involves training staff, educating patients, and coordinating care at psychiatry clinics. Patients with a major mental illness, such as depression or bipolar disorder, who are also dealing with alcohol use disorder, may be suitable candidates if they are already receiving treatment at one of the participating clinics. The goal is to ensure more individuals receive the appropriate medication to aid in managing alcohol use. As an unphased trial, this study provides patients an opportunity to contribute to innovative approaches in improving care for alcohol use disorder.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this implementation facilitation intervention is safe?

Research shows that the treatment being tested includes a method called external facilitation, used in healthcare to improve processes. This method does not involve medication or medical procedures, making it generally safe. Instead, it includes activities like training staff and educating patients to help doctors better prescribe medication for alcohol use disorder. Because it does not involve direct medical treatment, no safety issues have been reported, making it easy for participants to handle. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Implementation Facilitation for Alcohol Use Disorder because it takes a comprehensive approach that goes beyond individual therapy or medication. While traditional treatments often focus on counseling or medications like naltrexone and acamprosate, this method emphasizes external facilitation, staff training, patient education, audit and feedback, and care coordination. By improving how healthcare providers implement treatment plans, it has the potential to enhance patient outcomes on a larger scale, making it a promising avenue for more effective management of alcohol use disorder.

What evidence suggests that this implementation facilitation is effective for increasing MAUD prescribing?

Research has shown that certain strategies can improve medication use for alcohol use disorder (AUD). In this trial, participants will receive an Implementation Facilitation Intervention, which includes external facilitation, staff training, patient education, audit and feedback, and care coordination. One study tested a comprehensive approach and found it increased the frequency of considering and providing effective treatments for AUD. This approach aims to address obstacles like lack of knowledge and stigma around alcohol treatment. Another study found that similar methods improved screening and referrals for alcohol-related issues. These findings suggest that outside support could effectively increase medication use to treat AUD, especially in patients with major mental illness. ^{1 2 3 5 6}

Who Is on the Research Team?

Melanie Bennett

Principal Investigator

University of Maryland, Baltimore

Are You a Good Fit for This Trial?

This trial is for patients with major mental illness who also struggle with alcohol use disorder. It's being conducted in three psychiatry treatment clinics.

Inclusion Criteria

For prescribers: working as a prescriber, non-prescribing clinician, or administrator at one of the three participating clinics

For patients: has major mental illness (major depressive disorders, bipolar disorder, schizophrenia spectrum disorders, other psychotic disorders, posttraumatic stress disorder)

For patients: has Alcohol Use Disorder and is being treated in one of the three participating clinics

Exclusion Criteria

I am under 18 years old.

I am unable to understand or sign the informed consent form.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-implementation

Preparation phase involving clinic level education and training on MAUD, and setting up systems for screening and documentation

4 weeks

Implementation

External facilitation with clinic staff training, patient education, audit and feedback, and care coordination

6 months

Post-implementation Facilitation Sustainment

Clinics and champions continue implementation on their own with access to consultation from a MAUD clinician expert

6 months

Follow-up

Participants are monitored for MAUD outcomes after the sustainment phase

6 months

What Are the Treatments Tested in This Trial?

Interventions

• External Facilitation

Trial Overview The study is testing a strategy called 'Implementation Facilitation' to see if it helps doctors prescribe medications for alcohol use disorder more often in the psychiatric setting.

How Is the Trial Designed?

Group I: Implementation Facilitation Experimental Treatment 1 Intervention

This Implementation Facilitation Intervention will include external facilitation, staff training, patient education, audit and feedback, and care coordination.

Who Is Running the Clinical Trial?

University of Maryland, Baltimore

Lead Sponsor

Trials

729

Recruited

540,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5834954/

Barriers to and Facilitators of Alcohol Use Disorder ... Barriers included lack of knowledge and experience, beliefs that medications cannot replace specialty addiction treatment, and alcohol-related stigma.

2. jamanetwork.com jamanetwork.com/journals/jama-health-forum/fullarticle/2822018

Practice Facilitation to Address Unhealthy Alcohol Use in ... Main Outcomes and Measures Outcomes included the increase in recommended screening for UAU, brief interventions, referral for counseling, and ...

3. digitalcommons.unmc.edu digitalcommons.unmc.edu/cgi/viewcontent.cgi?article=1376&context=coph_slce

A Comprehensive Literature Review of Barriers and ... Alcohol use disorder (AUD) is the leading cause of preventable disability, mortality, and disparities in health outcomes (Probst et al., 2014).

4. jabfm.org jabfm.org/content/jabfp/37/6/1027.full.pdf

Improving Care for Unhealthy Alcohol Use: Results from ... A recent study examining the effects of eLearning in health care found benefits included increased accessibility, interactivity, flexibility, ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0740547217301903

Effects of a multifaceted implementation intervention to ... We developed and pilot tested a multifaceted implementation intervention to improve consideration and receipt of effective pharmacologic treatments for AUD.

6. academic.oup.com academic.oup.com/alcalc/article/60/2/agaf003/7996975

A qualitative exploration of the barriers and facilitators to the ... Alcohol use disorder has adverse implications for individuals' health, utilisation of healthcare services, and societal costs. There are a group ...