Rural MOUD Telemedicine in Primary Care Phase 1

Overview

The feasibility study (Phase 1) will examine the implementation of telemedicine (TM) in six rural clinics in two states/regions with varying levels of OBOT capacity.

Full Title of Study: “Rural Expansion of Medication Treatment for Opioid Use Disorder (Rural MOUD): Phase 1 Feasibility Study (CTN-0102)”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: July 29, 2021

Detailed Description

The dramatic increases in opioid overdose deaths across the nation, particularly in rural areas, call for a rapid expansion of access to medication treatment for opioid use disorder (MOUD).There is a need to study effective ways to expand treatment access and improve retention on MOUD in rural areas highly impacted by OUD. Telemedicine (TM) for MOUD offers an alternative or supplementary approach to delivering MOUD that may be suitable for rural clinics and patients with OUD. The objectives of the feasibility study are to study ways of incorporating TM into primary care clinics and to evaluate the associated outcomes, based on EHRs from the clinics and the TM vendor (i.e., patient days on MOUD) and participant surveys (e.g., opioid use). Additional outcomes of the feasibility study are feasibility and acceptability assessed from the perspectives of providers and participants via focus groups. A patient registry will be established in each clinic to track patients with OUD diagnoses, and those in the registry will be provided the opportunity to consent for sharing identified EHRs and participating in the follow-up surveys.

Interventions

  • Other: Integration of telemedicine for MOUD in primary care
    • Patients with opioid use disorder in rural primary care settings may be referred to receive telemedicine for medication treatment for opioid use disorder

Arms, Groups and Cohorts

  • Integration of telemedicine in primary care settings for MOUD
    • Primary care providers may refer OUD patients to receive telemedicine for MOUD

Clinical Trial Outcome Measures

Primary Measures

  • Patient days on MOUD from Electronic Health Records (EHR)
    • Time Frame: 9 months
    • Number of days patients receive MOUD based on EHR data

Secondary Measures

  • Number of OUD patients initiating/receiving MOUD
    • Time Frame: 9 months
    • Number of OUD patients initiating/receiving MOUD

Participating in This Clinical Trial

Inclusion Criteria

  • Aged 18-80 years old, inclusive, at the time of the qualifying visit – with OUD diagnosis – At least 1 visit to the participating clinics from 9 months before and 6 months after the date of intervention implementation

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 80 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of California, Los Angeles
  • Collaborator
    • National Institute on Drug Abuse (NIDA)
  • Provider of Information About this Clinical Study
    • Principal Investigator: Yih-Ing Hser, Principal Investigator – University of California, Los Angeles
  • Overall Official(s)
    • Yih-Ing Hser, Ph.D., Principal Investigator, University of California, Los Angeles

References

Hser YI, Mooney LJ, Baldwin LM, Ober A, Marsch LA, Sherman S, Matthews A, Clingan S, Fei Z, Zhu Y, Dopp A, Curtis ME, Osterhage KP, Hichborn EG, Lin C, Black M, Calhoun S, Holtzer CC, Nesin N, Bouchard D, Ledgerwood M, Gehring MA, Liu Y, Ha NA, Murphy SM, Hanano M, Saxon AJ. Care coordination between rural primary care and telemedicine to expand medication treatment for opioid use disorder: Results from a single-arm, multisite feasibility study. J Rural Health. 2023 Sep;39(4):780-788. doi: 10.1111/jrh.12760. Epub 2023 Apr 19.

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