Nurse Care Management for Opioid Use Disorder Treatment

作者：Paige D. Wartko, Jennifer F. Bobb, Denise M. Boudreau, Abigail G. Matthews, Jennifer McCormack, Amy K. Lee, Hongxiang Qiu, Onchee Yu, Noorie Hyun, Abisola Idu, Cynthia I. Campbell, Andrew J. Saxon, David S. Liu, Andrea Altschuler, Jeffrey H. Samet, Colleen T. LaBelle, Mohammad Zare-Mehrjerdi, Angela L. Stotts, Jordan M. Braciszewski, Mark T. Murphy, Douglas Dryden, Julia Hope Arnsten, Chinazo O. Cunningham, Viviana E. Horigian, José Szapocznik, Joseph E. Glass, Ryan M. Caldeiro, Rebecca C. Phillips, Mary Ann Shea, Gavin B. Bart, Robert P. Schwartz, Jennifer McNeely, Jane M. Liebschutz, Judith I. Tsui, Joseph O. Merrill, Gwen T. Lapham, Megan Addis, Katharine A. Bradley, PROUD Trial Collaborators, Megan M. Ghiroli, Leah Hamilton, Yong Hu, Jennifer Lahue, Amy M. Loree, Sean M. Murphy, Thomas F. Northrup, Dikla Shmueli‐Blumberg, Angela J. Silva, Zoe Weinstein, Mark TinFook Wong, Rachael P. Burganowski · 发表于：JAMA Internal Medicine · 年份：2023 · DOI：10.1001/jamainternmed.2023.5701 · 被引用次数：35 · 研究领域：Opioid Use Disorder Treatment、Substance Abuse Treatment and Outcomes、HIV, Drug Use, Sexual Risk

Importance: Few primary care (PC) practices treat patients with medications for opioid use disorder (OUD) despite availability of effective treatments. Objective: To assess whether implementation of the Massachusetts model of nurse care management for OUD in PC increases OUD treatment with buprenorphine or extended-release injectable naltrexone and secondarily decreases acute care utilization. Design, Setting, and Participants: The Primary Care Opioid Use Disorders Treatment (PROUD) trial was a mixed-methods, implementation-effectiveness cluster randomized clinical trial conducted in 6 diverse health systems across 5 US states (New York, Florida, Michigan, Texas, and Washington). Two PC clinics in each system were randomized to intervention or usual care (UC) stratified by system (5 systems were notified on February 28, 2018, and 1 system with delayed data use agreement on August 31, 2018). Data were obtained from electronic health records and insurance claims. An implementation monitoring team collected qualitative data. Primary care patients were included if they were 16 to 90 years old and visited a participating clinic from up to 3 years before a system's randomization date through 2 years after. Intervention: The PROUD intervention included 3 components: (1) salary for a full-time OUD nurse care manager; (2) training and technical assistance for nurse care managers; and (3) 3 or more PC clinicians agreeing to prescribe buprenorphine. Main Outcomes and Measures: The prima...