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J Stud Alcohol Drugs. 2017 Sep;78(5):735-744.

Promoting Adoption of Medication for Opioid and Alcohol Use Disorders Through System Change.

Author information

1
Center for Health Systems Research and Analysis, University of Wisconsin-Madison, Madison, Wisconsin.
2
Department of Public Administration and Policy, School of Public and International Affairs, University of Georgia, Athens, Georgia.
3
Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, Oregon.
4
OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, Oregon.
5
2M Research Services, Raleigh-Durham, North Carolina.
6
The Chalk Group, Washington, D.C.
7
School of Medicine, University of California at San Francisco, San Francisco, California.

Abstract

OBJECTIVE:

The Medication Research Partnership (MRP), a collaboration between a national commercial health plan and nine addiction treatment centers, implemented organizational and system changes to promote use of federally approved medications for treatment of alcohol and opioid use disorders.

METHOD:

A difference-in-differences analysis examined change over time in the percentage of patients receiving a prescription medication for alcohol or opioid use disorders treated in MRP (n = 9) and comparison (n = 15) sites.

RESULTS:

MRP clinics experienced a 2.4-fold increase in patients receiving an alcohol or opioid prescription (13.2% at baseline to 31.7% at 3 years after MRP initiation); comparison clinics experienced significantly less change (17.6% to 23.5%) with an adjusted difference-in-differences of 12.5% (95% CI [5.4, 19.6], p = .001). MRP sites increased the patients with prescriptions to treat opioid use disorder from 17.0% (baseline) to 36.8% (3 years after initiation), with smaller changes observed in comparison sites (23.2% to 24.0%) and a 3-year post-initiation adjusted difference-in-differences of 19% (95% CI [8.5, 29.5], p = .000). Medications for alcohol use disorders increased in both MRP (9.0% to 26.5%) and comparison sites (11.4% to 23.1%).

CONCLUSIONS:

Promoting the use of medications to support recovery required complex interventions. The Advancing Recovery System Change Model, initially developed in publicly funded systems of care, was successfully adapted for commercial sector use. The model provides a framework for providers and commercial health plans to collaborate and increase patient access to medications.

PMID:
28930061
PMCID:
PMC5675424
DOI:
10.15288/jsad.2017.78.735
[Indexed for MEDLINE]
Free PMC Article

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