Mobile treatment for opioid use disorder : Implementation of community-based, same-day medication access interventions
Copyright © 2023 Elsevier Inc. All rights reserved..
BACKGROUND: Medications for Opioid Use Disorder (MOUD) are lifesaving, but <20 % of individuals in the US who could benefit receive them. As part of the NIH-supported HEALing Communities Study (HCS), coalitions in several communities in Massachusetts and Ohio implemented mobile MOUD programs to overcome barriers to MOUD receipt. We defined mobile MOUD programs as units that provide same-day access to MOUD at remote sites. We aimed to (1) document the design and organizational structure of mobile programs providing same-day or next-day MOUD, and (2) explore the barriers and facilitators to implementation as well as the successes and challenges of ongoing operation.
METHODS: Program staff from five programs in two states (n = 11) participated in semi-structured interviews. Two authors conducted thematic analysis of the transcripts based on the domains of the social-ecological model and the semi-structured interview guide.
RESULTS: Mobile MOUD units sought to improve immediate access to MOUD ("Our answer is pretty much always, 'Yes, we'll get you started right here, right now,'"), advance equity ("making sure that we have staff who speak other languages, who are on the unit and have some resources that are in different languages,"), and decrease opioid overdose deaths. Salient program characteristics included diverse staff, including staff with lived experience of substance use ("She just had that personal knowledge of where we should be going"). Mobile units offered harm reduction services, broad medical services (in particular, wound care), and connection to transportation programs and incorporated consistency in service provision and telemedicine access. Implementation facilitators included trusting relationships with partner organizations (particularly pharmacies and correctional facilities), nuanced understanding of local politics, advertising, protocol flexibility, and on-unit prescriber hours. Barriers included unclear licensing requirements, staffing shortages and competing priorities for staff, funding challenges due to inconsistency in grant funding and low reimbursement ("It's not really possible that billing in and of itself is going to be able to sustain it"), and community stigma toward addiction services generally.
CONCLUSIONS: Despite organizational, community, and policy barriers, participants described mobile MOUD units as an innovative way to expand access to life-saving medications, promote equity in MOUD treatment, and overcome stigma.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:159 |
|---|---|
| Enthalten in: |
Journal of substance use and addiction treatment - 159(2024) vom: 21. Apr., Seite 209272 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Chatterjee, Avik [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Harm reduction |
|---|
| Anmerkungen: |
Date Completed 18.03.2024 Date Revised 19.04.2024 published: Print-Electronic ClinicalTrials.gov: NCT04111939 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.josat.2023.209272 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM366193090 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM366193090 | ||
| 003 | DE-627 | ||
| 005 | 20240420232213.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231227s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.josat.2023.209272 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1381.xml |
| 035 | |a (DE-627)NLM366193090 | ||
| 035 | |a (NLM)38128649 | ||
| 035 | |a (PII)S2949-8759(23)00324-7 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Chatterjee, Avik |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Mobile treatment for opioid use disorder |b Implementation of community-based, same-day medication access interventions |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 18.03.2024 | ||
| 500 | |a Date Revised 19.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT04111939 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Medications for Opioid Use Disorder (MOUD) are lifesaving, but <20 % of individuals in the US who could benefit receive them. As part of the NIH-supported HEALing Communities Study (HCS), coalitions in several communities in Massachusetts and Ohio implemented mobile MOUD programs to overcome barriers to MOUD receipt. We defined mobile MOUD programs as units that provide same-day access to MOUD at remote sites. We aimed to (1) document the design and organizational structure of mobile programs providing same-day or next-day MOUD, and (2) explore the barriers and facilitators to implementation as well as the successes and challenges of ongoing operation | ||
| 520 | |a METHODS: Program staff from five programs in two states (n = 11) participated in semi-structured interviews. Two authors conducted thematic analysis of the transcripts based on the domains of the social-ecological model and the semi-structured interview guide | ||
| 520 | |a RESULTS: Mobile MOUD units sought to improve immediate access to MOUD ("Our answer is pretty much always, 'Yes, we'll get you started right here, right now,'"), advance equity ("making sure that we have staff who speak other languages, who are on the unit and have some resources that are in different languages,"), and decrease opioid overdose deaths. Salient program characteristics included diverse staff, including staff with lived experience of substance use ("She just had that personal knowledge of where we should be going"). Mobile units offered harm reduction services, broad medical services (in particular, wound care), and connection to transportation programs and incorporated consistency in service provision and telemedicine access. Implementation facilitators included trusting relationships with partner organizations (particularly pharmacies and correctional facilities), nuanced understanding of local politics, advertising, protocol flexibility, and on-unit prescriber hours. Barriers included unclear licensing requirements, staffing shortages and competing priorities for staff, funding challenges due to inconsistency in grant funding and low reimbursement ("It's not really possible that billing in and of itself is going to be able to sustain it"), and community stigma toward addiction services generally | ||
| 520 | |a CONCLUSIONS: Despite organizational, community, and policy barriers, participants described mobile MOUD units as an innovative way to expand access to life-saving medications, promote equity in MOUD treatment, and overcome stigma | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Harm reduction | |
| 650 | 4 | |a Mobile health units | |
| 650 | 4 | |a Opiate overdose | |
| 650 | 4 | |a Opioid use disorder | |
| 650 | 4 | |a Vulnerable populations | |
| 700 | 1 | |a Baker, Trevor |e verfasserin |4 aut | |
| 700 | 1 | |a Rudorf, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Walt, Galya |e verfasserin |4 aut | |
| 700 | 1 | |a Stotz, Caroline |e verfasserin |4 aut | |
| 700 | 1 | |a Martin, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Kinnard, Elizabeth N |e verfasserin |4 aut | |
| 700 | 1 | |a McAlearney, Ann Scheck |e verfasserin |4 aut | |
| 700 | 1 | |a Bosak, Julie |e verfasserin |4 aut | |
| 700 | 1 | |a Medley, Bethany |e verfasserin |4 aut | |
| 700 | 1 | |a Pinkhover, Allyson |e verfasserin |4 aut | |
| 700 | 1 | |a Taylor, Jessica L |e verfasserin |4 aut | |
| 700 | 1 | |a Samet, Jeffrey H |e verfasserin |4 aut | |
| 700 | 1 | |a Lunze, Karsten |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of substance use and addiction treatment |d 2023 |g 159(2024) vom: 21. Apr., Seite 209272 |w (DE-627)NLM353076554 |x 2949-8759 |7 nnns |
| 773 | 1 | 8 | |g volume:159 |g year:2024 |g day:21 |g month:04 |g pages:209272 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.josat.2023.209272 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 159 |j 2024 |b 21 |c 04 |h 209272 | ||