The State of Oklahoma is among the States hardest hit by a combination of uncontrolled national trends in nonmedical uses of opioid prescription drugs, past-year heroin use, and opioid-related mortality. A highly rural state, Oklahoma is challenged to identify and reach persons with unmet treatment needs despite ongoing State efforts to improve access to community-based substance abuse treatment services, promote awareness of the opioid epidemic, foster safe prescribing of opioid prescription drugs, and prevent diversion. In response to the Agency for Healthcare Research and Quality?s (AHRQ) funding opportunity to expand access to medication- assisted treatment (MAT) in rural primary care, this project will develop, implement, and test an intervention to support primary care providers in three regions of rural Oklahoma in their adoption of MAT as an evidence- based strategy for treating persons with opioid use disorder. Objectives of the study include: ? Improving access to appropriate care for persons with or at risk of opioid use disorder (OUD) in heavily rural sections of the state that face particular challenges with opioid-related morality and/ or unmet treatment need; ? Preparing primary care providers to identify and care for persons with OUD using evidence-based and comprehensive treatment that provides a combination of pharmacologic and psychosocial therapies; ? Understanding and addressing potential barriers to the uptake of MAT in office-based settings; and ? Disseminating effective and replicable strategies for overcoming barriers to MAT adoption to help other rural communities improve access to and quality of care for persons with OUD. To accomplish these objectives, participating providers will be supported in their initiation and use of MAT through comprehensive training, case-based learning opportunities, practice facilitation, and individualized consultation on special topics. The implementation will be evaluated using a mixed-methods pre-/post- implementation design to assess changes in process of care and access to care for persons with OUD, as well as changes in provider attitudes and beliefs to assess the effectiveness of the implementation supports in overcoming known barriers to achieving the full promise of MAT in office-based settings.
Current trends in nonmedical uses of opioid prescription drugs, past-year heroin use, and opioid-related mortality are particularly hard-hitting on rural communities. With access to appropriate medical care already scarce in rural areas of healthcare professional shortage, preparing primary care providers to identify and treat patients misusing or abusing opioids becomes an important strategy in curbing the opioid epidemic and saving lives. This project proposes an implementation demonstration to support primary care providers in rural Oklahoma in adopting medication-assisted treatment as an evidence-based strategy for treating persons with opioid use disorder to expand access to care and address potential barriers to achieving the full promise of MAT in office-based settings.
