An organizational readiness intervention and randomized controlled trial to test strategies for implementing substance use disorder treatment into primary care: SUMMIT study protocol

Implementation Science

Claude M Setodji¹  Mimi Lind²  Karen Lamp²  Sarah B Hunter¹  Katherine E Watkins¹  Allison J Ober¹ 

[1] RAND Corporation, 1776 Main Street, Santa Monica 90407, CA, USA;Venice Family Clinic, 604 Rose Avenue, Venice 90291, CA, USA

关键词: ®Motivational interviewing;    Suboxone;    ®Buprenorphine/naloxone;    Vivitrol;    Extended-release injectable naltrexone;    Medication-assisted treatment;    Care coordination;    Collaborative care;    Primary care;    Evidence-based substance use disorder treatment;    Organizational readiness;    Implementation;   

Others  :  1218377
DOI  :  10.1186/s13012-015-0256-7

 received in 2015-04-02, accepted in 2015-04-23,  发布年份 2015

【 摘 要 】

Background

Millions of people who need treatment for substance use disorders (SUD) do not receive it. Evidence-based practices for treating SUD exist, and some are appropriate for delivery outside of specialty care settings. Primary care is an opportune setting in which to deliver SUD treatment because many individuals see their primary care providers at least once a year. Further, the Patient Protection and Affordable Care Act (PPACA) increases coverage for SUD treatment and is increasing the number of individuals seeking primary care services. In this article, we present the protocol for a study testing the effects of an organizational readiness and service delivery intervention on increasing the uptake of SUD treatment in primary care and on patient outcomes.

Methods/design

In a randomized controlled trial, we test the combined effects of an organizational readiness intervention consisting of implementation tools and activities and an integrated collaborative care service delivery intervention based on the Chronic Care Model on service system (patient-centered care, utilization of substance use disorder treatment, utilization of health care services and adoption and sustainability of evidence-based practices) and patient (substance use, consequences of use, health and mental health, and satisfaction with care) outcomes. We also use a repeated measures design to test organizational changes throughout the study, such as acceptability, appropriateness and feasibility of the practices to providers, and provider intention to adopt the practices. We use provider focus groups, provider and patient surveys, and administrative data to measure outcomes.

Discussion

The present study responds to critical gaps in health care services for people with substance use disorders, including the need for greater access to SUD treatment and greater uptake of evidence-based practices in primary care. We designed a multi-level study that combines implementation tools to increase organizational readiness to adopt and sustain evidence-based practices (EBPs) and tests the effectiveness of a service delivery intervention on service system and patient outcomes related to SUD services.

Trial registration

Current controlled trials: NCT01810159 webcite

【 授权许可】

   
2015 Ober et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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