Facilitating the Implementation of Interim Methadone to Increase Treatment Access

Friends Research Institute

Status: Completed

Conditions: Opioid-use Disorder

Treatments: Other: Usual Practice; Other: Implementation Facilitation

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04188977

U01DA046910 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The primary aim of this study is to evaluate the effectiveness of Implementation Facilitation (IF) in promoting increased accessibility to methadone treatment.

Full description

This is a Type 3 implementation-effectiveness type study using a modified stepped wedge design. The study's purpose is to examine the effectiveness of Implementation Facilitation (IF) to prompt participating Opioid Treatment Programs (OTPs) to utilize interim methadone treatment and other approaches to reduce OTP admission delays. Interim methadone treamtent is an evidence-based practice permitted under federal OTP regulations to provide methadone treatment without routine counseling for individuals requesting methadone treatment who otherwise would not be able to be admitted to such treatment within 14 days of request. The study will be conducted at six OTPs in the US that are unable to admit individuals within 14 days of their request for methadone treatment. The OTPs will participate in a baseline Pre-Implementation Phase, an Implementation Phase, followed by a Sustainability Phase. OTPs will be randomly assigned in groups of two to the order in which they will initiate the Implementation Phase. IF will be delivered at the level of the OTP staff and their state health department official responsible for OTP oversight. OTP staff and state health department officials will be interviewed regarding facilitators and barriers to implementing interim methadone and other approaches to reduce admission delays. De-identified data will be gathered from the OTPs on the effectiveness of IF in prompting the implementation of interim methadone and reducing admission delays.

Enrollment: 18 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria (Staff):

• OTP staff
• State health department staff responsible for OTP oversight

Exclusion Criteria:

• Unwilling to be interviewed

Inclusion Criteria (OTP applicants):

• requesting admission to OTP

Exclusion Criteria:

• None

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: Single Blind

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18 participants in 2 patient groups

Usual Practice

Other group

Description:

OTPs are able to request from state and federal health department officials to utilize interim methadone treatment to address admission delays in their OTP.

Treatment:

Other: Usual Practice

Implementation Facilitation

Experimental group

Description:

Implementation Facilitation (IF) will consist of educational outreach to OTP staff, identification of local champions, training, performance feedback, and learning collaborative for OTP staff and state health department officials.

Treatment:

Other: Implementation Facilitation