Study Finds IT MATTTRs Provider Education an Effective Resource for Increasing Buprenorphine Treatment
A recent study funded by the Agency for Healthcare Research and Quality (AHRQ) used a novel team-based approach, Implementing Technology and Medication Assisted Treatment Team Training in Rural Colorado (IT MATTTRs) to provide information, implementation support, and resources for primary care practice teams to improve treatment for opioid use disorder (OUD).
According to the study authors, evidence supports treatment for OUD with buprenorphine in primary care practices but there are barriers that slow implementation, including training staff members. Therefore, the study wanted to increase the number of rural primary care practices that provide OUD treatment with buprenorphine. However, implementing evidence-based guidelines for the use of buprenorphine has been slowed by complex definitions, misconceptions about the patients that need treatment, and inadequately trained staff. Unfortunately, that leads to a significant treatment gap for OUD, with only an estimated 20% of youth and adults with OUD receiving treatment. Those barriers to treatment are magnified in rural communities and primary care.
In an attempt to help patients in rural areas of Colorado, the High Plains Research Network (HPRN) and the Colorado Research Network (CaReNet) developed and implemented IT MATTTRs for medical treatment of OUD with buprenorphine. IT MATTTRs developed and implemented community-focused interventions to have conversations around OUD, increase knowledge of OUD, treatment with buprenorphine, and treatment-seeking behaviors. The program delivered training for teams focused on advanced primary care and patient-centered medical home literature. Forty-two primary care practice teams participated in the study and received IT MATTTRs training and support.
Participating practices reported an average of 4.7 treatment-related components initially as compared to 13 at a 12-month foll0w-up. The proportion of participating practices that provided or referred patients for treatment increased from 18.8% to 74.4%, an 87% increase in the number of buprenorphine prescriptions in the study region, compared with a 65% increase in the rest of the state. While new OUD treatment inductions did not significantly increase, patients in treatment for longer than six months did. Prescription Drug Monitoring Program data also show significant increases in patients per year with a prescription for buprenorphine with a zip code in the 24-county study region and patients who obtained their medication from a pharmacy in the study region increased significantly. Therefore, the study concludes, IT MATTTRs is an effective resource for implementing buprenorphine treatment for OUD in primary care.
The study believes there are several possible factors that may have resulted in the positive outcome. For one, the IT MATTTRs community-level interventions were associated with community members’ awareness of treatment for OUD in primary care. Secondly, the IT MATTTRs Practice Team Training reached 441 team members across various roles; those participants reported high levels of satisfaction and significantly higher self-rated ability to deliver treatment components after the training. Finally, primary care practices implemented many of the processes and components necessary for delivering treatment.