Grants and Contracts Details
Overdoses due to non-medical use of prescription opioids have become the leading cause of accidental deaths in the United States. Buprenorphine pharmacotherapy is a key intervention available to specialty addiction treatment organizations to treat opioid misuse and prevent overdose deaths. However, use of this therapy occurs in just 17% of these organizations. Treatment organizations’ efforts to provide buprenorphine treatment have been stymied by their limited success in recruiting physicians willing to prescribe the medication. A recent analysis found 24.1% of specialty treatment organizations using buprenorphine pharmacotherapy had to turn patients away because of insufficient buprenorphine prescribing capacity. Another study found that 43% of US counties had no buprenorphine prescribers. This proposal will test a bundle of practices, the Physician Recruiting Bundle (PRB), that was recently piloted in a buprenorphine implementation study that showed increases in buprenorphine physician recruitment by 50-100%. The practice bundle included physician educational forums (as stand-alone sessions or part of an existing medical meeting), establishing a medical residency rotation in addiction treatment facilities and other outreach efforts to medical schools, flexible contracting and scheduling with physicians, using academic detailing during marketing, and using telemedicine to bring a physician to the treatment organization. These practices will be implemented using the NIATx Organizational Change model in a mixed methods study that begins with a qualitative phase and then a randomized controlled trial (RCT). The qualitative phase will identify 80 treatment organizations in 4 states that are seeking buprenorphine prescribing physicians and will measure the degree which these organizations already have implemented portions of the PRB bundle. Data from this phase will be used to generate pairs of similar provider organizations. In the RCT, organizations in each pair will be randomized into one of two arms: 1) control; and 2) organizational implementation of the PRB. This study has two aims: (1) Increase the number of physician buprenorphine prescribers (as measured by assigned buprenorphine prescription slots) in specialty addiction treatment organizations using the PRB, and (2) Test the PRB’s impact on associations with the physician recruitment factors of, resources dedicated to physician recruitment, physician recruiter motivation, staff physician satisfaction (physicians want to go where other physicians are happy), and PRB implementation fidelity (using a mediation analysis). By increasing access to an evidence-based approach capable of reducing the morbidity and mortality of opioid addiction, this trial has significant public health impact. Should the PRB be successful, the approach could be used to recruit physicians to other high need areas such as adult and adolescent psychiatry practices and as inner city and rural health centers.
|Effective start/end date||4/1/16 → 12/31/21|
- University of Wisconsin: $143,788.00
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