Stagewise Implementation-To-Target- Medications for Addiction Treatment (SITT-MAT)

Stanford University

Status: Active, not recruiting

Conditions: Addiction, Opioid

Treatments: Other: NIATx/MAT Academy; Other: Enhanced Monitoring and Feedback (EMF); Other: NIATx-Internal Facilitation (NIATx-IF); Other: NIATx-External Facilitation (NIATx-EF)

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT05343793

60711

1R01DA052975-01A1 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The purpose of this study is to expand access to medications for opioid use disorder (MOUD) in specialty addiction programs in Washington State. Sixty-four addiction treatment programs will participate in an adaptive implementation strategy trial that uses a stagewise implementation-to-target (stepped "care" type) approach whereby organizations engage in increasingly intensive implementation strategies as needed. Organizations are moved to a follow-up/sustainment arm once they have met the implementation targets described below. The design also includes an external comparator arm, which consists of 510 addiction treatment programs that are not participating in the study and will mimic as study controls.

The sequence of implementation strategies are:

1. Enhanced Monitoring and Feedback
2. NIATx/MAT Academy
3. Randomization to either NIATx Internal Facilitation or NIATx External Facilitation
4. Assignment to NIATx External Facilitation if outcome targets are not achieved in the NIATx Internal Facilitation arm

Implementation targets are:

1. Reach - At least 75% of patients with opioid use disorder (OUD) receiving MOUD for three consecutive months
2. Adoption - At least 1 integrated MOUD prescriber actively prescribing MOUD
3. Implementation - a total score ≥ 4 on the Integrating Medications for Addiction Treatment (IMAT) Index.

Contextual moderators and mediators of performance on target outcomes as a function of the implementation strategy step will be examined, as will the costs associated with participation in the sequence of implementation strategies.

Enrollment: 47 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Addiction treatment programs in Washington State
• Residential (detoxification or rehabilitation) or outpatient (intensive outpatient or outpatient) levels of care
• Primary care clinics, including Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs)

Exclusion criteria

• Opioid treatment programs

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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47 participants in 5 patient groups

Path 1

Experimental group

Description:

Enhanced Monitoring and Feedback

Treatment:

Other: Enhanced Monitoring and Feedback (EMF)

Path 2

Experimental group

Description:

Enhanced Monitoring and Feedback + NIATx/MAT Academy

Treatment:

Other: Enhanced Monitoring and Feedback (EMF)

Other: NIATx/MAT Academy

Path 3

Experimental group

Description:

Enhanced Monitoring and Feedback + NIATx/MAT Academy + NIATx External Facilitation

Treatment:

Other: NIATx-External Facilitation (NIATx-EF)

Other: Enhanced Monitoring and Feedback (EMF)

Other: NIATx/MAT Academy

Path 4

Experimental group

Description:

Enhanced Monitoring and Feedback + NIATx/MAT Academy + NIATx Internal Facilitation

Treatment:

Other: NIATx-Internal Facilitation (NIATx-IF)

Other: Enhanced Monitoring and Feedback (EMF)

Other: NIATx/MAT Academy

Path 5

Experimental group

Description:

Enhanced Monitoring and Feedback + NIATx/MAT Academy + NIATx Internal Facilitation + NIATx External Facilitation

Treatment:

Other: NIATx-External Facilitation (NIATx-EF)

Other: NIATx-Internal Facilitation (NIATx-IF)

Other: Enhanced Monitoring and Feedback (EMF)

Other: NIATx/MAT Academy