Overview:
Opioid overdose and the condition that drives it – opioid use disorder (OUD) – are major causes of morbidity and mortality among Veterans and high-priority targets for quality improvement in the VA healthcare system. However, access to effective treatment of opioid use disorder (OUD) —medication-assisted therapy (MAT)—remains limited in the VA New England Healthcare System ( 1). While we know MAT prevents overdose and suicide, as well as medical complications associated with addiction, some facilities are falling short. Therefore, in collaboration with 1 Leadership, the overall goal of this PII start-up project is to deploy implementation facilitation—an evidence-based implementation strategy—to improve the uptake of and adherence to the Stepped Care for OUD model, thereby improving the rates of MAT among Veterans with opioid use disorder (see figure below) at two VA facilities with the lowest proportion of Veterans on MAT: VAMC Manchester, NH and the Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA.
Aims
Methodology
This PII start-up project will employ well-established formative evaluation methods to evaluate the effectiveness of and drive refinements to our implementation strategy. Additionally, investigators will use an interrupted time series design to assess the impact of their project on important clinical targets, specifically, the proportion of Veterans with OUD on MAT and retention in treatment on MAT. Finally, they will evaluate cost using budget impact analysis and develop a web- based implementation toolkit to serve as an implementation manual for future dissemination.
Expected Impacts
These evaluation and product development efforts will prime successful scale-up and dissemination efforts should the implementation facilitation strategy demonstrate effectiveness.
Principal Investigator: William Becker, MD (William.Becker4@va.gov ); 1 Project Lead: Lisa Lehmann, MD, PhD (Lisa.Lehmann@va.gov ).
Operations Partner(s): I, VA New England Healthcare System