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Research Studies is a compilation of published research articles funded by ´óÏóÊÓƵor authored by ´óÏóÊÓƵresearchers.

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1 to 25 of 65 Research Studies Displayed
Childs E, Swan H, Evans L
´óÏóÊÓƵAuthor: Perfetto D, Hogan E
A toolkit to implement opioid quality improvement efforts in primary care: findings from a mixed-methods study.
This study evaluated the How-to-Implement Toolkit for the Six Building Blocks program, which aims to improve opioid management for chronic pain in primary care settings. Eight healthcare organizations with 62 clinics participated in the evaluation. Through interviews and surveys with clinical staff, researchers found that while organizations valued the Toolkit's resources, they preferred having practice facilitator support during implementation. Participants reported using specific tools rather than the entire Toolkit. The findings emphasize the importance of implementation support for opioid quality improvement initiatives in primary care settings. The Toolkit and related resources are available through the ´óÏóÊÓƵ.
AHRQ-authored.
Citation: Childs E, Swan H, Evans L . A toolkit to implement opioid quality improvement efforts in primary care: findings from a mixed-methods study. J Opioid Manag 2025 Jan-Feb; 21(1):29-40. doi: 10.5055/jom.0894..
Keywords: Quality Improvement, Primary Care, Opioids, Medication, Quality of Care, Implementation
Holtrop JS, Mullen R, Curcija K
Increasing medication assisted treatment in rural primary care practice: a qualitative comparative analysis from IT MATTTRs Colorado.
The purpose of this mixed-methods study was to investigate conditions behind an increase in medication assisted treatment (MAT) in primary care practices in rural Colorado. Researchers used data from interviews, observations, surveys, and practice-reports. Participants were staff members from rural primary care practices in Colorado. The results indicated that having a MAT-waivered prescribing clinician on staff and a MAT system in place were necessary conditions for providing MAT. Practice size was also associated with differences in conditions for MAT provision. The researchers concluded that implementation of MAT in rural primary care is a complex task that may benefit from behavioral health resources and clinicians with prior MAT experience.
AHRQ-funded; HS025056.
Citation: Holtrop JS, Mullen R, Curcija K . Increasing medication assisted treatment in rural primary care practice: a qualitative comparative analysis from IT MATTTRs Colorado. Frontiers in Medicine 2024 Oct 2; 11:1450672. doi: 10.3389/fmed.2024.1450672..
Keywords: Medication, Primary Care, Rural Health, Rural/Inner-City Residents, Opioids, Substance Abuse, Behavioral Health
Growdon ME, Hunt LJ, Miller MJ
eConsultation for deprescribing among older adults: clinician perspectives on implementation barriers and facilitators.
This study examined clinician perspectives on barriers/facilitators of using eConsults for deprescribing among older adults within a university health network. The authors conducted semi-structured interviews with primary care physicians (PCPs), geriatricians, and pharmacists. The most common barriers and facilitators to deprescribing for PCPs was that they considered deprescribing important but identified myriad barriers (e.g., time constraints, fragmented clinical care, lack of pharmacist integration, and patient/family resistance). Other barriers to the use of eConsults for deprescribing included the limits of contextual information available through electronic health record (vs. face-to-face) to render specific and actionable eConsults (e.g., knowledge of prior deprescribing attempts). Geriatricians and PCPs both highlighted the limits of contextual information available through electronic health record (vs. face-to-face) to render specific and actionable eConsults (e.g., knowledge of prior deprescribing attempts). A targeted process where eConsults could be offered for select patients based on key factors and accepted or declined by PCPs with pithy recommendations in a timely manner created interested by all groups.
AHRQ-funded; HS026383; HS029738.
Citation: Growdon ME, Hunt LJ, Miller MJ . eConsultation for deprescribing among older adults: clinician perspectives on implementation barriers and facilitators. J Gen Intern Med 2024 Oct; 39(13):2461-70. doi: 10.1007/s11606-024-08899-0..
Keywords: Telehealth, Health Information Technology (HIT), Elderly, Implementation, Medication, Primary Care
Laytner LA, Trautner BW, Nash S
Situations predisposing primary care patients to use antibiotics without a prescription in the United States.
This study assessed prevalence of intended usage of non-prescription antibiotics for predefined situations and identified sociodemographic characteristics associated with intended use for these situations. Patient surveys were conducted in the waiting rooms of six safety-net primary care clinics and two emergency departments in a private healthcare system. Their responses indicated that the most common situations leading to non-prescription antibiotic use were perceived high cost of doctor visits, having leftover prescription antibiotics, and experiencing symptom relief with prior use of antibiotics. The authors concluded that stewardship interventions should consider the types of situations that drive patients' use of antibiotics without a prescription.
AHRQ-funded; HS026901.
Citation: Laytner LA, Trautner BW, Nash S . Situations predisposing primary care patients to use antibiotics without a prescription in the United States. Antimicrob Steward Healthc Epidemiol 2024 Sep 9; 4(1):e121. doi: 10.1017/ash.2024.361..
Keywords: Primary Care, Antibiotics, Medication, Antimicrobial Stewardship
Laytner LA, Trautner BW, Nash S
Lack of knowledge of antibiotic risks contributes to primary care patients' expectations of antibiotics for common symptoms.
The authors surveyed patients in public and private primary care clinics in Texas to study the prevalence and predictors of antibiotic expectations for common symptoms or illnesses. Responses revealed that public clinic patients were nearly twice as likely to expect antibiotics for sore throat, diarrhea, and cold/flu than patients in private clinics. Lack of knowledge of potential risks of antibiotic use was associated with increased antibiotic expectations for diarrhea and cold/flu symptoms. The authors concluded that antibiotic stewardship interventions should tailor patient education materials to include information on antibiotic risks and guidance on appropriate antibiotic indications.
AHRQ-funded; HS026901.
Citation: Laytner LA, Trautner BW, Nash S . Lack of knowledge of antibiotic risks contributes to primary care patients' expectations of antibiotics for common symptoms. Ann Fam Med 2024 Sep-Oct; 22(5):421-25. doi: 10.1370/afm.3161..
Keywords: Antibiotics, Primary Care, Antimicrobial Stewardship, Health Literacy, Medication
Hartung DM, Kassakian SZ, Hendricks MA
Effect of integration of prescription drug monitoring program data in the electronic health record on queries by primary care providers.
This study evaluated the impact of prescription drug monitoring program (PDMP) data in the electronic health record (EHR) on provider query rates within twelve primary care clinics in one academic medical center. Using linked data from the EHR and state PDMP program, the authors evaluated changes in PDMP query rates using a stepped-wedge observational design where integration was implemented in three waves (four clinics per wave) over a five-month period (May, July, September 2019). Multivariable negative binomial general estimating equations (GEE) models were used to assess changes in PDMP query rates, overall and across several provider and clinic-level subgroups. Among 206 providers in PDMP integrated clinics, the average number of queries per provider per month increased significantly from 1.43 pre-integration to 3.94 post-integration, a 2.74-fold increase. Those in the lowest quartile of PDMP use pre-integration increased 36.8-fold after integration, significantly more than other pre-integration PDMP use quartiles.
AHRQ-funded; HS028119.
Citation: Hartung DM, Kassakian SZ, Hendricks MA . Effect of integration of prescription drug monitoring program data in the electronic health record on queries by primary care providers. Health Informatics J 2024 Apr-Jun; 30(2):14604582241259337. doi: 10.1177/14604582241259337.
Keywords: Medication, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bridges NC, Taber R, Foulds AL
Medications for opioid use disorder in rural primary care practices: patient and provider experiences.
This study’s purpose was to gain a better understanding of the barriers and facilitators operating at multiple levels to access or provide medications for opioid use disorder (MOUD) in rural Pennsylvania. The authors interviewed patients and providers who were involved in the Rural Access to Medication Assisted Treatment in Pennsylvania (RAMP) Project, which facilitated adoption of MOUD in rural primary care clinics. The study conducted 35 semi-structured interviews with MOUD patients and MOUD providers participating in RAMP. The interviews were coded by the study team. Themes from the qualitative interviews were organized in five nested levels: individual, interpersonal, health care setting, community, and public policy. Patients and providers agreed on many barriers (such as lack of providers, lack of transportation, insufficient rapport and trust in patient-provider relationship, and cost, etc.); however, their interpretation of the barrier, or indicated solution, diverged in meaningful ways. Patients described their experiences in broad terms pointing to the social determinants of health while providers focused on their professional roles, responsibilities, and operations within the primary care setting.
AHRQ-funded; HS025072.
Citation: Bridges NC, Taber R, Foulds AL . Medications for opioid use disorder in rural primary care practices: patient and provider experiences. J Subst Use Addict Treat 2023 Nov; 154:209133. doi: 10.1016/j.josat.2023.209133..
Keywords: Rural Health, Rural/Inner-City Residents, Opioids, Medication, Substance Abuse, Behavioral Health, Primary Care
Young RA, Gurses AP, Fulda KG
Primary care teams' reported actions to improve medication safety: a qualitative study with insights in high reliability organising.
The purpose of this qualitative study was to examine actions by primary care teams to improve medication safety. During 2019-2020, the researchers utilized one-on-one, semi-structured interviews with 21 primary care physicians and their team members at four primary care sites serving patients with mostly low socioeconomic status in the Southwest United States. The study found that primary care teams described their actions in medication safety primarily in making standard-of-care medical decisions, patient-shared decision-making, educating patients and their caregivers, providing asynchronous care separate from office visits and providing clinical infrastructure. The majority of the actions required individual-level customization, such as restricting the supply of specific medications prescribed and simplifying the medication regimens of specific patients. Primary care teams engaged high reliability organization principles taking steps to improve resilience in patient work systems and by anticipating and moderating risks. The actions of the primary care teams demonstrated their safety organizing efforts as responses to many other agents in multiple settings that they could neither control nor coordinate easily.
AHRQ-funded; HS027277.
Citation: Young RA, Gurses AP, Fulda KG . Primary care teams' reported actions to improve medication safety: a qualitative study with insights in high reliability organising. BMJ Open Qual 2023 Sep; 12(3). doi: 10.1136/bmjoq-2023-002350..
Keywords: Medication: Safety, Medication, Primary Care, Patient Safety
McClintock HF, Edmonds SE, Bogner HR
Adherence patterns to oral hypoglycemic agents among primary care patients with type 2 diabetes.
This study’s objective was to examine patterns of adherence to oral hypoglycemic agents among primary care patients with type 2 diabetes mellitus and to assess whether these patterns were associated with baseline intervention allocation, sociodemographic characteristics, and clinical indicators. Adherence patterns for 72 participants were examined by Medication Event Monitoring System (MEMS) caps at baseline and 12 weeks. Participants were randomly allocated to a Patient Prioritized Planning (PPP) intervention or a control group. A card-sort task was used in the PPP intervention to identify health-related priorities that included social determinants of health to address medication nonadherence. Afterward, a problem-solving process was used to address unmet needs involving referral to resources. Patients were found to be either adherent, increasingly adherent, or non-adherent. Participants assigned to the PPP intervention were significantly more likely to have a pattern of improving adherence and adherence than participants assigned to the control group.
AHRQ-funded; HS023445.
Citation: McClintock HF, Edmonds SE, Bogner HR . Adherence patterns to oral hypoglycemic agents among primary care patients with type 2 diabetes. Prim Care Diabetes 2023 Apr;17(2):180-84. doi: 10.1016/j.pcd.2023.01.014.
Keywords: Diabetes, Patient Adherence/Compliance, Primary Care, Medication, Chronic Conditions
Levin JS, Komanduri S, Whaley C
Association between hospital-physician vertical integration and medication adherence rates.
This study’s goal was to test the association between vertical integration of primary care providers (PCPs) and adherence rates for anti-diabetics, renin angiotensin system antagonists (RASA), and statins. Data was extracted from Medicare Part B outpatient fee-for-service claims and Medicare Part D event data from 2014 to 2017. There was a 23% increase in the proportion of patients who had a vertically integrated PCP during the study period. Changes in adherence did not differ significantly between patients based on whether their PCP became integrated. However, among patients with PCPs who become integrated, there were significant decreases in patients who were above 80 years old, were Black, Asian, Hispanic, or Native America, and had greater comorbidities for all three classes.
AHRQ-funded; HS024067.
Citation: Levin JS, Komanduri S, Whaley C . Association between hospital-physician vertical integration and medication adherence rates. Health Serv Res 2023 Apr; 58(2):356-64. doi: 10.1111/1475-6773.14090.
Keywords: Medication, Patient Adherence/Compliance, Medicare, Primary Care
Gay HC, Yu J, Persell SD
Comparison of sodium-glucose cotransporter-2 inhibitor and glucagon-like peptide-1 receptor agonist prescribing in patients with diabetes mellitus with and without cardiovascular disease.
Researchers sought to describe trends in prescribing for sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) to reduce cardiovascular events and mortality in adult patients with type 2 diabetes mellitus (T2DM) in diverse care settings. Their focus was on outpatient clinics in a midwestern integrated health system and small- and medium-sized community-based primary care practices and health centers in three Midwestern states. Results showed that an increase in prescription rates was greater for SGLT2is than for GLP1-RAs in a large integrated medical center and community primary care practices; overall, prescription rates for eligible patients were low, and the researchers observed racial disparities.
AHRQ-funded; HS026385; HS023921.
Citation: Gay HC, Yu J, Persell SD . Comparison of sodium-glucose cotransporter-2 inhibitor and glucagon-like peptide-1 receptor agonist prescribing in patients with diabetes mellitus with and without cardiovascular disease. Am J Cardiol 2023 Feb 15; 189:121-30. doi: 10.1016/j.amjcard.2022.10.041..
Keywords: Diabetes, Cardiovascular Conditions, Chronic Conditions, Medication, Primary Care
White A, Fulda KG, Blythe R
Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety.
The purpose of this narrative review was to further define the nature of collaboration between pharmacists and primary care providers in improving medication safety in community settings, and to describe related barriers and strategies. The researchers searched PubMed studies published between January 2000 and December 2020 using search terms including: "collaboration," "community pharmacy," "patient safety," "medication safety," and "primary care physician." The identified articles were placed into 3 categories: 1) defining collaboration, 2) types of collaboration, and 3) barriers and solutions to collaboration. The authors concluded that medication review and other strategies are a common form of collaboration between pharmacists and primary care providers, and that barriers to that collaboration can include erroneous beliefs regarding roles, variation in access to clinical information, and differences in community pharmacy practice.
AHRQ-funded; HS027277.
Citation: White A, Fulda KG, Blythe R . Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety. Expert Opin Drug Saf 2022 Nov;21(11):1357-64. doi: 10.1080/14740338.2022.2147923..
Keywords: Provider: Pharmacist, Primary Care, Medication, Patient Safety, Community-Based Practice
Campbell NL, Pitts C, Corvari C
Deprescribing anticholinergics in primary care older adults: experience from two models and impact on a continuous measure of exposure.
The purpose of this study was to assess two pilot pharmacist-based advanced practice deprescribing intervention models and their impact on patients’ exposure to high-risk anticholinergics. The researchers conducted pilot studies of a collaborative clinic-based pharmacist deprescribing intervention and a telephone-based pharmacist deprescribing intervention. Deprescribing was defined as a discontinuation or dose reduction. Patients participating in the clinic-based pharmacy model were aged 55 years and older and were referred for deprescribing at a specialty clinic. Patients participating in the telephone-based pharmacy model were aged 65 years and older and called by a clinical pharmacist for deprescribing without referral. The study found that among the 24 medications deemed eligible for deprescribing for the18 patients in the clinic-based model, 23 were deprescribed. The clinic-based deprescribing model resulted in a 93% reduction in median annualized total standardized dose (TSD), 56% lowered their annualized exposure below a cognitive risk threshold, and 17% of medications were represcribed within 6 months. Among the 24 medications deemed eligible for deprescribing for the 24 patients in the telephone-based pharmacy model, 50% were deprescribed. There was no change in the median annualized TSD, the annualized TSD was lowered below a cognitive risk threshold in 46%, and no medications were represcribed within 6 months. The researchers concluded that pharmacist-based deprescribing successfully reduced exposure to high-risk anticholinergics in the study population.
AHRQ-funded; HS24384.
Citation: Campbell NL, Pitts C, Corvari C . Deprescribing anticholinergics in primary care older adults: experience from two models and impact on a continuous measure of exposure. Journal of the American College of Pharmacy 2022 Oct;5(10):1039-47. doi: 10.1002/jac5.1682..
Keywords: Elderly, Primary Care, Medication, Provider: Pharmacist, Medication: Safety, Patient Safety
Pestka DL, Paterson NL, Brummel AR
Barriers and facilitators to implementing pharmacist-provided comprehensive medication management in primary care transformation.
The objective of this study was to identify barriers and facilitators when integrating pharmacist-provided comprehensive medication management (CMM) services into a health system's team-based primary care transformation (PCT) using the Consolidated Framework for Implementation Research. Findings showed that identifying and addressing implementation barriers and facilitators early during PCT rollout was critical to the success of team-based services such as CMM and becoming a learning health system. Further, clinical pharmacists providing CMM represented a valuable interdisciplinary care team member who can help to improve healthcare quality and access to primary care.
AHRQ-funded; HS026379.
Citation: Pestka DL, Paterson NL, Brummel AR . Barriers and facilitators to implementing pharmacist-provided comprehensive medication management in primary care transformation. Am J Health Syst Pharm 2022 Jul 22;79(15):1255-65. doi: 10.1093/ajhp/zxac104..
Keywords: Medication, Provider: Pharmacist, Primary Care, Implementation, Practice Improvement
Yu J, Wang AA, Zimmerman LP
A cohort analysis of statin treatment patterns among small-sized primary care practices.
The purpose of this retrospective cohort analysis study was to describe statin treatment patterns in small-sized primary care practices and explore the patient and practice factors that are related to lack of statin treatment. The researchers included all statin-eligible adults (13,330) who received care at one of 53 Healthy Hearts in the Heartland (H3) practices, a cardiovascular care quality improvement initiative, between 2013 and 2016. The study found that among 43% of patients (5,780), there was no record of moderate- to high-intensity statin therapy. A lack of appropriate intensity statin therapy was independently associated with the female sex, a younger age, and lower low-density lipoprotein cholesterol (LDL-C). Also associated with lower appropriate intensity statin use was a higher proportion of patients insured by Medicaid and having only family medicine trained physicians (vs. having at least one internal medicine trained physician) at the practice. A lack of appropriate intensity statin therapy was greater in independent practices than in Federally Qualified Health Centers (FQHCs). The study concluded that factors influencing lack of statin treatment vary by practice setting, emphasizing the role of approaches that are customized to individual settings.
AHRQ-funded; HS023921.
Citation: Yu J, Wang AA, Zimmerman LP . A cohort analysis of statin treatment patterns among small-sized primary care practices. J Gen Intern Med 2022 Jun;37(8):1845-52. doi: 10.1007/s11606-021-07191-9..
Keywords: Cardiovascular Conditions, Medication, Practice Patterns, Primary Care
Meiselbach MK, Drake C, Saloner B
Medicaid managed care: access to primary care providers who prescribe buprenorphine.
This study examined variation in access to in-network buprenorphine-prescribing primary care providers that can treat opioid use disorder among Medicaid managed care enrollees. Approximately 32.2% of Medicaid enrollees had fewer than one in-network network buprenorphine-prescribing primary care providers per 100,000 county residents. There was on average a greater number of in-network buprenorphine-prescribing primary care providers in states with higher compared with lower overdose death rates, but most enrollees lived in areas with a shortage of these providers. The authors found that a 25 percent higher network participation rate by prescribers compared with nonprescribers could improve the probability that enrollees see a prescriber by approximately 25 percent.
AHRQ-funded; HS000029.
Citation: Meiselbach MK, Drake C, Saloner B . Medicaid managed care: access to primary care providers who prescribe buprenorphine. Health Aff 2022 Jun;41(6):901-10. doi: 10.1377/hlthaff.2021.01719..
Keywords: Medicaid, Primary Care, Access to Care, Medication, Care Management, Opioids, Substance Abuse, Behavioral Health
Holtrop JS, Mullen R, Curcija K
The balance between serving the community and the reality of treating opioid use disorder in rural primary care practices.
The purpose of this qualitative study was to investigate clinician and staff perceptions related to medication assisted treatment (MAT) for opioid use disorder, particularly buprenorphine treatment, in rural primary care practices. Staff members from rural 42 practices were interviewed. Although there was almost no provision of MAT, policies and procedures to reduce opioid prescribing were usually in place and many practices expressed interest in learning more to help their patients and local communities.
AHRQ-funded; HS025056.
Citation: Holtrop JS, Mullen R, Curcija K . The balance between serving the community and the reality of treating opioid use disorder in rural primary care practices. J Health Care Poor Underserved 2022; 33(1):253-67. doi: 10.1353/hpu.2022.0019..
Keywords: Opioids, Substance Abuse, Behavioral Health, Primary Care, Rural Health, Medication
Zittleman L, Curcija K, Nease DE
Increasing capacity for treatment of opioid use disorder in rural primary care practices.
Evidence supports treatment for opioid use disorder (OUD) with buprenorphine in primary care practices (PCPs). Barriers that slow implementation of this treatment include inadequately trained staff. This study aimed to increase the number of rural PCPs providing OUD treatment with buprenorphine. This evaluation described the impact of a practice team training on the implementation and delivery of OUD treatment with buprenorphine in PCPs of rural Colorado.
AHRQ-funded; HS025065.
Citation: Zittleman L, Curcija K, Nease DE . Increasing capacity for treatment of opioid use disorder in rural primary care practices. Ann Fam Med 2022 Jan-Feb;20(1):18-23. doi: 10.1370/afm.2757..
Keywords: Opioids, Rural Health, Primary Care, Substance Abuse, Behavioral Health, Training, Implementation, Medication
White AEC, Hood-Medland EA, Kravitz RL
Visit linearity in primary care visits for patients with chronic pain on long-term opioid therapy.
Physicians and patients report frustration after primary care visits for chronic pain. The need to shift between multiple clinical topics to address competing demands during visits may contribute to this frustration. This study created a novel measure, "visit linearity," to assess visit organization and examined whether visits that required less shifting back and forth between topics were associated with better patient and physician visit experiences.
AHRQ-funded; HS022236.
Citation: White AEC, Hood-Medland EA, Kravitz RL . Visit linearity in primary care visits for patients with chronic pain on long-term opioid therapy. J Gen Intern Med 2022 Jan;37(1):78-86. doi: 10.1007/s11606-021-06917-z..
Keywords: Opioids, Pain, Chronic Conditions, Primary Care, Medication
Sussman AL, Crawford JN, Brakey HR
Use of a benchmark tracking assessment to support expansion of buprenorphine for treatment of opioid use disorder in primary care.
Barriers to the expansion of opioid use disorder (OUD) treatment in primary care using buprenorphine are well documented. Providers require support along a continuum. A systematic tracking framework to enhance provider progress along this continuum is lacking. The investigators developed a benchmark tracking assessment (BTA) as part of data collection in a 5-year study to examine the impact of provider participation in an online intervention to support expansion of buprenorphine treatment for OUD in rural primary care.
AHRQ-funded; HS025345.
Citation: Sussman AL, Crawford JN, Brakey HR . Use of a benchmark tracking assessment to support expansion of buprenorphine for treatment of opioid use disorder in primary care. J Am Board Fam Med 2021 Nov-Dec;34(6):1216-20. doi: 10.3122/jabfm.2021.06.210111..
Keywords: Opioids, Primary Care, Medication, Substance Abuse, Behavioral Health
Campbell NL, Holden RJ, Tang Q
Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults.
This study tested the effectiveness of a multicomponent behavioral intervention to reduce the use of high-risk anticholinergic medications in primary care older adults. Ten primary care clinics within Eskenazi Health in Indianapolis were selected to test the intervention. The intervention included provider- and patient-focused components. The provider-focused component was a computerized decision support system alerting the presence of a high-risk anticholinergic and offering dose- and indication-specific alternatives; while the patient-focused component was a story-based video providing education and modeling an interaction with a healthcare provider. The intervention occurred from April 2019 through March 2020. A total of 552 older adults had primary care visits during the study period. Only 3 out of 259 provider-focused alerts led to a medication change. Of the 276 staff alerts, 4.7% were confirmed to activate the patient-focused intervention.
AHRQ-funded; P30HS024384.
Citation: Campbell NL, Holden RJ, Tang Q . Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults. J Am Geriatr Soc 2021 Jun;69(6):1490-99. doi: 10.1111/jgs.17121..
Keywords: Elderly, Medication, Primary Care, Clinical Decision Support (CDS), Shared Decision Making
Simon CB, Klein JW, Bradley KA
Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders.
One potential challenge of treating OUD in primary care is comorbidity. Mental health and substance use disorders and chronic pain are common in patients with Opioid Use Disorders (OUDs) in specialty OUD treatment settings and on confidential surveys, but the prevalence of such comorbidity in primary care patients with OUD has not been confirmed. This brief report addressed that gap.
AHRQ-funded; HS023173.
Citation: Simon CB, Klein JW, Bradley KA . Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders. J Gen Intern Med 2021 Jun;36(6):1799-801. doi: 10.1007/s11606-020-05820-3..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Primary Care
Tsui JI, Akosile MA, Lapham GT
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV. The objective of this retrospective observational cohort study was to describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV.
AHRQ-funded; HS026369.
Citation: Tsui JI, Akosile MA, Lapham GT . Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV. J Gen Intern Med 2021 Apr;36(4):930-37. doi: 10.1007/s11606-020-06389-7..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Hepatitis, Human Immunodeficiency Virus (HIV), Primary Care
Nourjah P, Kato E
´óÏóÊÓƵAuthor: Nourjah P, Kato E
"One size does not fit all" and other lessons learned from grants for implementation of the ´óÏóÊÓƵmedication assisted treatment for opioid use disorder in rural primary care.
This article summarizes lessons learned from five ´óÏóÊÓƵgrants to implement Medication for Opioid Use Disorder (MOUD) in rural primary care practices. The experience of these projects suggests that recruiting providers in rural areas and engaging them to initiate and sustain provision of MOUD is very difficult. Implementation of MOUD in rural primary care is challenging but success is more likely if implementers are attentive to the needs of individual providers, are flexible and can tailor implementation to the local situation, and can provide on-going support.
AHRQ-authored.
Citation: Nourjah P, Kato E . "One size does not fit all" and other lessons learned from grants for implementation of the ´óÏóÊÓƵmedication assisted treatment for opioid use disorder in rural primary care. Subst Abus 2021;42(2):136-39. doi: 10.1080/08897077.2021.1891600..
Keywords: Implementation, Opioids, Substance Abuse, Primary Care, Rural Health, Medication
Cole ES, DiDomenico E, Green S
The who, the what, and the how: a description of strategies and lessons learned to expand access to medications for opioid use disorder in rural America.
This study looked at the problems of treatment access for opioid use disorder (OUD) in rural areas within the United States. Providers must complete 8-24 hours of training to obtain the Drug Addiction Treatment Act (DATA) 2000 waiver to have the legal authority to prescribe buprenorphine. The authors executed 5 AHRQ-funded dissemination and implementation grants to study and address barriers to providing Medications for Opioid Use Disorder Treatment (MOUD), including psychosocial supports. Obtaining the DATA 2000 waiver was found to be just one component of meaningful treatment using MOUD, and there are other significant barriers that providers face daily. The researchers’ initiatives and common lessons learned across their grants are summarized and recommendations are offered how primary care providers can be better supported to expand access to MOUD across rural America.
AHRQ-funded.
Citation: Cole ES, DiDomenico E, Green S . The who, the what, and the how: a description of strategies and lessons learned to expand access to medications for opioid use disorder in rural America. Subst Abus 2021;42(2):123-29. doi: 10.1080/08897077.2021.1891492..
Keywords: Opioids, Medication, Primary Care, Rural Health, Substance Abuse, Access to Care

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