J1 – Coordinated Medicated Assisted Treatment for Opioid Use Disorder: Collaborative Care between Community Organizations and Health Care Access Points

Summary

Background: Integrated primary care for opioid use disorder (OUD) increases access to addiction treatment in rural and urban communities. By reducing stigma, providing medication assisted treatment (MAT), and addressing medical, behavioral and social complexity, primary care contributes to the addiction care continuum. We describe preliminary successes and challenges of a collaborative initiative to support primary care practice implementation of integrated care for patients with OUD. Population: Patients with OUD at participating primary care practices across 7 Pennsylvania counties. From 2015-18, the area saw increasing overdose deaths, driven largely by fentanyl, rising hepatitis C infections, high burden of chronic pain, unintended pregnancies, and limited access to behavioral health and addiction services. Study Design: Combined narrative and case series describes partner engagement to build a coordinated support system for primary care, practice experiences, and patient outcomes. Procedures: Descriptive data about development of the model collected through participatory narrative process. Practices mapped to describe integrated care processes Background: Integrated primary care for opioid use disorder (OUD) increases access to addiction treatment in rural and urban communities. By reducing stigma, providing medication assisted treatment (MAT), and addressing medical, behavioral and social complexity, primary care contributes to the addiction care continuum. We describe preliminary successes and challenges of a collaborative initiative to support primary care practice implementation of integrated care for patients with OUD. Population: Patients with OUD at participating primary care practices across 7 Pennsylvania counties. From 2015-18, the area saw increasing overdose deaths, driven largely by fentanyl, rising hepatitis C infections, high burden of chronic pain, unintended pregnancies, and limited access to behavioral health and addiction services. Study Design: Combined narrative and case series describes partner engagement to build a coordinated support system for primary care, practice experiences, and patient outcomes. Procedures: Descriptive data about development of the model collected through participatory narrative process. Practices mapped to describe integrated care processes and partnerships as they enroll in project. Practice experiences described through team debriefs and training evaluations. Patient data re behavioral/addiction diagnoses, interventions, engagement and effectiveness at each location collected through electronic health records and from structured intake and follow up interviews. Results: Key practice/system parameters, team roles and support measures that facilitate/inhibit change, preliminary patient outcomes.