Sustaining alcohol and opioid use disorder treatment in primary care: a mixed methods study.
Implement Sci
; 13(1): 83, 2018 06 18.
Article
en En
| MEDLINE
| ID: mdl-29914524
ABSTRACT
BACKGROUND:
Efforts to integrate substance use disorder treatment into primary care settings are growing. Little is known about how well primary care settings can sustain treatment delivery to address substance use following the end of implementation support.METHODS:
Data from two clinics operated by one multi-site federally qualified health center (FQHC) in the US, including administrative data, staff surveys, interviews, and focus groups, were used to gather information about changes in organizational capacity related to alcohol and opioid use disorder (AOUD) treatment delivery during and after a multi-year implementation intervention was executed. Treatment practices from the intervention period were compared to practices after the intervention period to examine whether the practices were sustained. Data from staff surveys and interviews were used to examine the factors related to sustainment.RESULTS:
The two clinics sustained multiple components of AOUD care 1 year following the end of implementation support, including care coordination, psychotherapy, and medication-assisted treatment. Some of the practices were modified over time, for example, screening became less frequent by design, while use of care coordination and psychotherapy for AOUDs expanded. Participants identified staff training and funding for medications as key challenges to sustaining treatment.CONCLUSIONS:
Following a multi-year implementation intervention, a large FQHC continued to deliver AOUD treatment. Access to external funding and staff support appeared to be critical elements for sustaining care over time. TRIAL REGISTRATION clinicaltrials.gov identifier NCT01810159.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
11_ODS3_cobertura_universal
/
1_ASSA2030
/
2_ODS3
/
8_ODS3_consumo_sustancias_psicoactivas
Problema de salud:
11_delivery_arrangements
/
11_financial_arrangements
/
1_geracao_evidencia_conhecimento
/
2_sustancias_psicoativas
/
8_alcohol
/
8_opioid_abuse
Asunto principal:
Atención Primaria de Salud
/
Prestación Integrada de Atención de Salud
/
Alcoholismo
/
Práctica Clínica Basada en la Evidencia
/
Trastornos Relacionados con Opioides
Tipo de estudio:
Prognostic_studies
/
Qualitative_research
Límite:
Adult
/
Child, preschool
/
Female
/
Humans
Idioma:
En
Revista:
Implement Sci
Año:
2018
Tipo del documento:
Article
País de afiliación:
Estados Unidos