HOMER is a national study. Primary care practices from around the country can join! To participate in this study, each practice must have:
At least one clinician, either a physician or advanced practice provider, with a DEA waiver to prescribe medication assisted treatment (MAT) with buprenorphine
Provided MAT to at least one patient by the spring of 2021
The ability to enroll approximately 10 MAT patients (6 – 20 patients is the acceptable range) over a 12-month period.
A practice clinician and staff member that can attend a virtual Kick-Off Orientation Event (in March or April 2021)
Agreement to have your patients randomly assigned to use one of the three comparison MAT induction methods
Agreement to track the clinical progress and outcomes of your MAT patients using a study supplied format.
HOMER is a three-year study.
Practices have 12 months to identify potential patient participants, beginning in April 2021.
Patient participants will be followed for nine months.
Practices need to have conducted at least one MAT induction for OUD prior to enrolling their first study participant. We are here to help! Contact us if you need some assistance to activate MAT in your practice.The evidence-based IT MATTTRs Practice Team Training and community awareness programs are available to get your practice and community ready for MAT. Several topic-specific MAT Forums are held multiple times a month.
Every practice will attend a virtual Kick-Off Orientation event that is being scheduled in early 2021.
After the kickoff, we will start enrolling patients. When a practice identifies a patient who is eligible and interested in the study, they will refer them to the research team, who will consent and enroll them. Then, each patient who joined the study is randomized to either home, office, or telehealth MAT induction.
The participating practice will then provide home, office, or teleheath MAT induction based on the patient’s randomization.
**It is not required that your practice be providing home, office, and remote observed-based inductions already, although we recommend you gain some experience with all three methods prior to starting to approach patients about the study. We have resources and support to familiarize you and get you started with the induction methods you might not have experience with.**
Participating practices will be asked to complete surveys and maintain patient tracking logs. Surveys should take about 10 minutes to complete.
A limited number of practices will be asked to participate in interviews with the study team. Interviews will be scheduled with 2-3 practice staff members and should take about 30 minutes to complete.
Yes, practices will be compensated a stipend for the time and effort they will provide to participate in the study. Practices will be paid $200 for two staff members to attend the required Practice Orientation, $200 per patient enrolled in the study, and $35/month/patient for nine months of monitoring and tracking. (For example, a practice that enrolls 12 patients and has 10 of those patients provide follow-up data for 9 months would receive a payment of $5700.)
Practice staff that are involved with the interviews will receive a $50 gift card for their participation.
In our experience,
primary care practices have more patients experiencing opioid dependence or OUD
than they realize if they do not regularly screen patients. Participants are identified by their
clinician as having opioid dependence and either 1) addiction as defined
by DSM-V criteria for OUD and/or 2) chronic pain with long-term, high dose
opioid use (greater than one year and morphine equivalent daily dose higher
than recommended by the CDC.
Yes. Patients who have previously gone
through induction for MAT (started treatment) are eligible for HOMER.
This does not need to be their first induction. There is no restriction
on number of previous inductions. We will document that information.
Yes. However, the patient will not be re-enrolled and will not be re-randomized. We will continue follow-up with the patient based on their initial enrollment date. Whatever induction method and treatment is used after the patient’s initial randomization will be done at the clinician’s discretion. We will record that information as part of follow-up, but the initial assigned arm will remain the same for the purpose of our analysis.
Please note that patient eligibility criteria for initial enrollment in HOMER include that the patient be identified by their clinician as having opioid dependence and either 1) addiction as defined by DSM-V criteria for OUD and/or 2) chronic pain with long-term, high dose opioid use (greater than one year and morphine equivalent daily dose higher than recommended by the CDC). However, if a patient enrolls and starts treatment, stops treatment, then starts up again, there is no required amount of time between stopping and re-starting treatment. Again, we will document that.
MAT related visits and prescriptions are covered by virtually all payers.