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QUERI Implementation Guide

Section II Part 2: Tools and Toolkits

Substance Use Disorders QUERI

All materials described below are part of the Opioid Agonist Therapy Monitoring System, a complete toolkit to support implementation of evidence-based practices in opioid agonist therapy (OAT) clinics. For a copy of the complete toolkit, please contact Hildi Hagedorn, PhD, Substance Use Disorders (SUD) QUERI Implementation Coordinator .

This fact sheet summarizes recent evidence regarding best practices in methadone dosing and the relationship of adequate dosing to treatment outcomes.

• Methadone Dosing Summary

This is a one-page consensus statement developed by a panel of experts in OAT that contains dosing recommendations for physicians prescribing methadone.

• Dosing Consensus Statement

This is an algorithm designed to assist physicians in establishing an effective methadone dose for new OAT patients.

• Methadone Dosing Algorithm

This is a tool designed to assist OAT teams in evaluating their compliance with methadone dosing best-practice recommendations.

• Methadone Dosing Review Form

This fact sheet summarizes recent evidence regarding standards for counseling services in OAT and the relationship of adequate counseling services to treatment outcomes.

• OAT Counseling Summary

This fact sheet summarizes recent evidence regarding the relationship between a long-term maintenance orientation to OAT and improved patient outcomes.

• Orientation Summary

This is a 14-item questionnaire developed by John Caplehorn that can be used to evaluate staff’s acceptance of a maintenance-orientated approach to OAT treatment.

• Abstinence Orientation Scale

This fact sheet summarizes the principles of effective contingency management interventions, as well as recent evidence regarding the relationship of contingency management interventions to improved treatment outcomes.

• Contingency Management Summary

This document contains several tools designed to assist OAT teams in implementing effective contingency management interventions. Tools include a detailed example of a contingency management intervention, a worksheet for staff to complete as a team to assist them in determining what type of contingency management intervention would fit into their clinic structure, and a sample case manager/patient contingency management contract.

• Contingency Management Implementation Tools

This CD ROM contains a Microsoft Excel program that OAT clinics can use to enter data on key patient treatment and outcome variables (e.g., dose, frequency of counseling visits, number of take-home doses, frequency of urine screens, and percentage of urine screens positive for opioids). The program allows clinics to quickly and easily view summary statistics and create feedback graphs by case manager, or for the clinic as a whole. The CD also contains a PowerPoint tutorial that walks users through the process of data entry and feedback production. For a copy of this CD please contact the SUD QUERI Implementation Research Coordinator (Hildi.Hagedorn@va.gov).

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