Opioid Use Disorder has seen an epidemic rise in the United States over the past decade. More than 250 million prescriptions for opioids are written each year along with increasing rates of illegal heroin use. Greater than 4 million Americans report using prescription pain medicine for non-medical reasons. Colorado has outpaced the rest of the nation and recently ranked as high as number 2 in the nation for rates of self-reported nonmedical use of prescription pain killers. Opioid overdoses killed 41 Coloradans per month in 2014 and 14 of the 24 counties in our proposed project have drug overdose rates greater than 16 per 100,000 placing them among the worst in the nation. There are evidence-based guidelines and recommendations for prescribing opioids and for treating Opioid Use Disorder (OUD). However, the magnitude of the work required to disseminate and implement evidence from medical research into clinical practice has been underestimated. Myriad barriers to implementation include: complex definitions, the diverse nature of primary care, and unique cultural aspects or rural communities. Implementation must be more than simply transposing one program into another venue. Over the past 5 years, the High Plains Research Network in rural eastern and southern Colorado has identified Opioid Use Disorder as a primary concern to our physicians, practices, and community members. HPRN providers and community members point out the problems they face; lack of community knowledge and awareness of OUD and medication assisted treatment (MAT), limited access to diagnostic and treatment services for OUD, and the complete lack of MAT. The HPRN has a goal to change the trajectory of this epidemic, improve the community level awareness of OUD, and successfully manage patients with OUD through primary care practice-based Medication Assisted Treatment. First, we propose to increase local community awareness and knowledge by completing a Boot Camp Translation, transforming the complex language and concepts of OUD and MAT into locally relevant, actionable messages and materials. Second, we will provide up-to-date evidence-based education on OUD and MAT comparing onsite and online training models. Finally, we will provide rural primary care practices with Opisafe, a robust web-based opioid and MAT patient engagement and monitoring system that provides valuable patient-centered follow-up tracking and complies with and meets all federal and state regulatory requirements. Mixed-method evaluation will identify the impact of community awareness on implementation success, identify the best methods for practice and provider team- based education, and the impact of an innovative web-based registry and tracking system on implementation and patient outcomes.
Opioid overdoses kill more than 40 Coloradans per month and 14 of the 24 counties in our rural network have higher drug overdose rates placing them among the worst in the nation. We propose to increase local community awareness and knowledge by completing a Boot Camp Translation, transforming the complex language and concepts of OUD and MAT into locally relevant, actionable messages and materials. We will provide up-to-date evidence-based education on OUD and MAT comparing onsite and online training models and implement Opisafe, a robust web-based opioid and MAT patient engagement and monitoring system.
