Covid 19 Clinical Trials

The purpose of this study is to evaluate the impact of (1) Implementation Facilitation (IF) on rates of provision of Emergency Department (ED)-initiated buprenorphine/naloxone (BUP) treatment with referral for ongoing medication-assisted treatment (MAT) and the (2) effectiveness of IF on patient engagement in formal addiction treatment at 30 days.

NCT03023930 Opioid Use Disorder Other: Standard Dissemination Practice Other: Implementation Facilitation (IF)

MeSH:Disease Emergencies Substance-Related Disorders

Primary Outcomes

Description: The primary implementation outcome will be evaluated assessing the rate of ED-initiated BUP therapy with referral for ongoing MAT over the 12 month period.

Measure: Implementation (Considered the Primary Outcome)

Time: 12 months

Description: The primary effectiveness outcome is defined as the rates of patient engagement in formal addiction treatment on the 30th day post enrollment.

Measure: Effectiveness

Time: 30 Days Post Enrollment

Secondary Outcomes

Description: Fidelity will be measured using a critical action checklist relating to the provision of ED-initiated BUP with referral for ongoing MAT in eligible patients.

Measure: Implementation: Fidelity

Time: Baseline Period (Baseline)

Description: Fidelity will be measured using a critical action checklist relating to the provision of ED-initiated BUP with referral for ongoing MAT in eligible patients.

Measure: Implementation: Fidelity

Time: IF Evaluation Period (18 months)

Description: ED provider readiness and preparedness ruler score to initiate BUP and provide referral for ongoing MAT

Measure: Implementation: ED provider Readiness and Preparedness Ruler Score

Time: Pre IF (Baseline)

Description: ED provider readiness and preparedness ruler score to initiate BUP and provide referral for ongoing MAT

Measure: Implementation: ED provider Readiness and Preparedness Ruler Score

Time: Post IF (6 months)

Description: ED provider readiness and preparedness ruler score to initiate BUP and provide referral for ongoing MAT

Measure: Implementation: ED provider Readiness and Preparedness Ruler Score

Time: post IF Evaluation Period (12 months)

Description: ED ORCA score relating to ED-initiated BUP with referral for ongoing MAT

Measure: Implementation: ED Organizational Readiness to Change Assessment (ORCA) Score

Time: Pre IF (Baseline)

Description: ED ORCA score relating to ED-initiated BUP with referral for ongoing MAT

Measure: Implementation: ED Organizational Readiness to Change Assessment (ORCA) Score

Time: Post IF (6 months)

Description: ED ORCA score relating to ED-initiated BUP with referral for ongoing MAT

Measure: Implementation: ED Organizational Readiness to Change Assessment (ORCA) Score

Time: Post IF Evaluation Period (12 months)

Description: Community opioid treatment provider/program readiness and preparedness ruler score to continue MAT for patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community Readiness and Preparedness Ruler Score

Time: Pre IF (Baseline)

Description: Community opioid treatment provider/program readiness and preparedness ruler score to continue MAT for patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community Readiness and Preparedness Ruler Score

Time: Post IF (6 months)

Description: Community opioid treatment provider/program readiness and preparedness ruler score to continue MAT for patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community Readiness and Preparedness Ruler Score

Time: post IF Evaluation Period (12 months)

Description: Community opioid treatment provider/program ORCA score relating to receiving patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community ORCA Score

Time: Pre IF (Baseline)

Description: Community opioid treatment provider/program ORCA score relating to receiving patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community ORCA Score

Time: Post IF (6 months)

Description: Community opioid treatment provider/program ORCA score relating to receiving patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community ORCA Score

Time: post IF Evaluation Period (12 months)

Description: Self-reported days of illicit opioid use (past 7 days) as measured by Time-Line Follow-Back methods at 30 days

Measure: Effectiveness: Opioid Use