Home or Clinic: What Works Best In Medication Assisted Treatment For Opioid Use Disorder?
New Award to CU Anschutz Medical Campus Researchers Paves Way to Find the AnswerRobert | Family Medicine Dec 16, 2019
The University of Colorado Department of Family Medicine Research team has netted a major award to fund an innovative study aimed at advancing medication-assisted treatment (MAT) with buprenorphine in patients suffering from opioid use disorder.
The more than $5 million grant comes from the Patient-Centered Outcomes Research Institute (PCORI).
Under the direction of co-principal investigators Linda Zittleman, MSPH, co-director of the High Plains Research Network and Donald E. Nease, Jr., MD, Vice Chair for Community, the funding seeks to determine if long-term treatment outcomes differ in patients that start their MAT (called induction) in a primary care office versus at home or other unobserved setting. The study will also provide evidence for which patients or circumstances are better suited for one method over the other.
This national study, led out of Colorado, will enlist the power of practice-based research networks within the State Networks of Colorado Ambulatory Practices & Partners (SNOCAP), its national partner, the American Academy of Family Physicians’ National Research Network (NRN), and community and patient partnerships.
“We are incredibly excited about this opportunity,” says Linda Zittleman. “This study is the result of many conversations with clinicians and community members around the state of Colorado and the country, from California to Montana to Iowa. They want to know, “What is the best way to start MAT for this patient at this time?”
Both home and office-based MAT induction methods have pros and cons. The patient’s experiences during the induction phase of treatment is critical to long-term treatment and quality of life. Previous studies primarily report on short-term outcomes 30 to 90 days out. Zittleman says this study will describe how patients do much further down the road.
“MAT delivered in primary care settings can be such a game-changer – a life-saver – for patients suffering from OUD. Few treatments for chronic conditions have such an immediate impact on preventing death, and primary care is an important source of care for this chronic condition. Yet, many clinicians and practice teams aren’t sure how best to incorporate MAT into their practices. Patients often do not know the choices available to them to start treatment or which one is better for them. We aim to help clinicians and care teams provide MAT for OUD based on the best evidence.”
This study builds on the Agency for Healthcare Research and Quality (AHRQ) funded IT MATTTRs study in the High Plains Research Network in eastern Colorado and the Colorado Research Network in the San Luis Valley. The goal is to engage 100 primary care practices and 1000 patients to help determine which induction method works better for long-term patient success and for which patients. The three-year study is scheduled to begin in early 2020.
References for Fast Facts:
Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United StatesResults from the 2014 National Survey on Drug Use anHealth (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/data/