Multi-model implementation of evidence-based care in the treatment of opioid use disorder in Pennsylvania

J Subst Abuse Treat. 2019 Nov:106:58-64. doi: 10.1016/j.jsat.2019.08.016. Epub 2019 Aug 28.

Abstract

Pennsylvania has the third highest rate of death due to drug overdose (44.3 per 100,000) in the country, which is significantly higher than the national rate. This continues to have drastic societal impact. Medication assisted treatment (MAT), which includes opioid agonist medications, is the gold standard in treatment for OUD; however, a significant gap remains between the number of individuals in need of treatment and the number of MAT providers. Penn State Health established a system to address the opioid epidemic through the Pennsylvania Coordinated Medication Assisted Treatment program utilizing lessons learned from existing validated models. Connecting primary care sites and hospital systems through a combination of Hub and Spoke, bridge clinic services provided at the Hub, peer recovery services, Project Extension for Community Health Outcomes (ECHO), and layered emergency department (ED) initiation of buprenorphine, this model is an innovative approach that addresses many known barriers to MAT treatment initiation. Early results within the first six months indicate significantly shortened wait time for patients seeking treatment, provision of waiver training to 70 local physicians to prescribe buprenorphine, and improved knowledge and ability to provide patient care for providers participating in our first Project ECHO cohort.

Keywords: Addiction; Hub-and-spoke system; Medication assisted treatment; Opioid.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Buprenorphine / administration & dosage*
  • Emergency Service, Hospital / organization & administration
  • Evidence-Based Medicine / organization & administration*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Models, Organizational
  • Opiate Substitution Treatment / methods*
  • Opioid Epidemic
  • Opioid-Related Disorders / drug therapy*
  • Patient Acceptance of Health Care
  • Pennsylvania
  • Physicians / organization & administration
  • Practice Patterns, Physicians' / statistics & numerical data
  • Primary Health Care / organization & administration

Substances

  • Buprenorphine