Coaching for Performance Improvement in Opioid Use Disorder

Recruiting at 3 trial locations

Overseen By Charles Neighbors, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: NYU Langone Health

Disqualifiers: Medicare, Age over 64, others

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

Compensation: Varies

Number of Visits: Unknown

7950 Participants Needed

Trial Summary

What is the purpose of this trial?

This project will develop and test quality measures for and a facilitation model to help addictions treatment clinics increase use of medicines for opioid use disorders, retain clients longer in care, and help more people move into successful recovery. At the end of the project, we will have developed specific training and coaching protocols as well as electronic clinical support tools to guide quality improvement that can be disseminated within New York and the rest of the country. The study will test a clinic-level intervention that uses external facilitators to provide guidance to addictions clinics and contain three key components: 1) training on data driven management; 2) training and guidance on patient-centered care and OUD medication; and 3) electronic tools for shared decision making and patient progress monitoring.

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 data supports the effectiveness of the treatment Metrics-driven quality improvement (MDQI) for opioid use disorder?

The study on peer recovery coaches shows that integrating trained peers into healthcare teams can improve outpatient treatment engagement and reduce hospitalizations for substance use disorder, suggesting that similar coaching methods in MDQI could enhance treatment outcomes for opioid use disorder. ^{1 2 3 4 5}

How does the treatment 'Metrics-driven quality improvement (MDQI)' differ from other treatments for opioid use disorder?

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 providers, rather than directly treating the patient with medication. This approach aims to improve the utilization of existing medications for opioid use disorder by supporting healthcare providers in implementing effective treatment practices. ^{1 2 3 5 6}

Research Team

Charles Neighbors, PhD

Principal Investigator

NYU Langone Health

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

Group I: Metrics-driven quality improvement (MDQI) intervention Experimental Treatment 1 Intervention

Group II: Control Active Control 1 Intervention

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+

Findings from Research

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.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer recovery coaches in general medical settings: Changes in utilization, treatment engagement, and opioid use. Magidson, JF., Regan, S., Powell, E., et al.[2021]

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.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Enhancing Use of Medications for Opioid Use Disorder Through External Coaching. [2023]

2. England pubmed.ncbi.nlm.nih.gov

A facilitation model for implementing quality improvement practices to enhance outpatient substance use disorder treatment outcomes: a stepped-wedge randomized controlled trial study protocol. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

West Virginia's model of buprenorphine expansion: Preliminary results. [2021]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Validation and endorsement of health system performance measures for opioid use disorder in British Columbia, Canada: A Delphi panel study. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Peer recovery coaches in general medical settings: Changes in utilization, treatment engagement, and opioid use. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Office-Based Opioid Treatment with Buprenorphine (OBOT-B): Statewide Implementation of the Massachusetts Collaborative Care Model in Community Health Centers. [2018]