Promoting adoption of medication for opioid and alcohol use disorders through system change

James H. Ford, Amanda J. Abraham, Nicoleta Lupulescu-Mann, Raina Croff, Kim A. Hoffman, Kelly Alanis-Hirsch, Mady Chalk, Laura Schmidt, Dennis McCarty

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The Medication Research Partnership (MRP), a collaboration between a national commercial health plan and nine addiction treatment centers, implemented organizational and system changes to promote use of federally approved medications for treatment of alcohol and opioid use disorders. Method: A difference-in-differences analysis examined change over time in the percentage of patients receiving a prescription medication for alcohol or opioid use disorders treated in MRP (n = 9) and comparison (n = 15) sites. Results: MRP clinics experienced a 2.4-fold increase in patients receiving an alcohol or opioid prescription (13.2% at baseline to 31.7% at 3 years after MRP initiation); comparison clinics experienced significantly less change (17.6% to 23.5%) with an adjusted difference-in-differences of 12.5% (95% CI [5.4, 19.6], p = .001). MRP sites increased the patients with prescriptions to treat opioid use disorder from 17.0% (baseline) to 36.8% (3 years after initiation), with smaller changes observed in comparison sites (23.2% to 24.0%) and a 3-year post-initiation adjusted difference-in-differences of 19% (95% CI [8.5, 29.5], p = .000). Medications for alcohol use disorders increased in both MRP (9.0% to 26.5%) and comparison sites (11.4% to 23.1%). Conclusions: Promoting the use of medications to support recovery required complex interventions. The Advancing Recovery System Change Model, initially developed in publicly funded systems of care, was successfully adapted for commercial sector use. The model provides a framework for providers and commercial health plans to collaborate and increase patient access to medications.

Original languageEnglish (US)
Pages (from-to)735-744
Number of pages10
JournalJournal of Studies on Alcohol and Drugs
Volume78
Issue number5
DOIs
StatePublished - Sep 1 2017

Fingerprint

system change
Opioid Analgesics
medication
alcohol
Alcohols
Research
Prescriptions
Health
Organizational Innovation
Recovery
Therapeutics
organizational change
health
addiction

ASJC Scopus subject areas

  • Health(social science)
  • Toxicology
  • Psychiatry and Mental health

Cite this

Promoting adoption of medication for opioid and alcohol use disorders through system change. / Ford, James H.; Abraham, Amanda J.; Lupulescu-Mann, Nicoleta; Croff, Raina; Hoffman, Kim A.; Alanis-Hirsch, Kelly; Chalk, Mady; Schmidt, Laura; McCarty, Dennis.

In: Journal of Studies on Alcohol and Drugs, Vol. 78, No. 5, 01.09.2017, p. 735-744.

Research output: Contribution to journalArticle

Ford, JH, Abraham, AJ, Lupulescu-Mann, N, Croff, R, Hoffman, KA, Alanis-Hirsch, K, Chalk, M, Schmidt, L & McCarty, D 2017, 'Promoting adoption of medication for opioid and alcohol use disorders through system change', Journal of Studies on Alcohol and Drugs, vol. 78, no. 5, pp. 735-744. https://doi.org/10.15288/jsad.2017.78.735
Ford, James H. ; Abraham, Amanda J. ; Lupulescu-Mann, Nicoleta ; Croff, Raina ; Hoffman, Kim A. ; Alanis-Hirsch, Kelly ; Chalk, Mady ; Schmidt, Laura ; McCarty, Dennis. / Promoting adoption of medication for opioid and alcohol use disorders through system change. In: Journal of Studies on Alcohol and Drugs. 2017 ; Vol. 78, No. 5. pp. 735-744.
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abstract = "The Medication Research Partnership (MRP), a collaboration between a national commercial health plan and nine addiction treatment centers, implemented organizational and system changes to promote use of federally approved medications for treatment of alcohol and opioid use disorders. Method: A difference-in-differences analysis examined change over time in the percentage of patients receiving a prescription medication for alcohol or opioid use disorders treated in MRP (n = 9) and comparison (n = 15) sites. Results: MRP clinics experienced a 2.4-fold increase in patients receiving an alcohol or opioid prescription (13.2{\%} at baseline to 31.7{\%} at 3 years after MRP initiation); comparison clinics experienced significantly less change (17.6{\%} to 23.5{\%}) with an adjusted difference-in-differences of 12.5{\%} (95{\%} CI [5.4, 19.6], p = .001). MRP sites increased the patients with prescriptions to treat opioid use disorder from 17.0{\%} (baseline) to 36.8{\%} (3 years after initiation), with smaller changes observed in comparison sites (23.2{\%} to 24.0{\%}) and a 3-year post-initiation adjusted difference-in-differences of 19{\%} (95{\%} CI [8.5, 29.5], p = .000). Medications for alcohol use disorders increased in both MRP (9.0{\%} to 26.5{\%}) and comparison sites (11.4{\%} to 23.1{\%}). Conclusions: Promoting the use of medications to support recovery required complex interventions. The Advancing Recovery System Change Model, initially developed in publicly funded systems of care, was successfully adapted for commercial sector use. The model provides a framework for providers and commercial health plans to collaborate and increase patient access to medications.",
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