2020
Integrated stepped alcohol treatment for patients with HIV and at-risk alcohol use: a randomized trial
Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Deng Y, Fiellin LE, O’Connor P, Bedimo R, Gibert CL, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Tate JP, Justice AC, Bryant KJ, Fiellin DA. Integrated stepped alcohol treatment for patients with HIV and at-risk alcohol use: a randomized trial. Addiction Science & Clinical Practice 2020, 15: 28. PMID: 32727618, PMCID: PMC7388231, DOI: 10.1186/s13722-020-00200-y.Peer-Reviewed Original ResearchConceptsRisk alcohol useAlcohol useAlcohol treatmentHealth of patientsEvidence-based strategiesWeek 24HIV outcomesRoutine careTelephone boosterPhysician managementEnhancement therapyHIVPWHPatientsTrialsTarget populationTreatmentAlcohol-related researchMulti-pronged approachOutcomesParticipantsInsufficient numberTherapyPopulationMethodsInComputerized Cognitive Behavioral Therapy for Substance Use Disorders in a Specialized Primary Care Practice: A Randomized Feasibility Trial to Address the RT Component of SBIRT.
Tetrault JM, Holt SR, Cavallo DA, O'Connor PG, Gordon MA, Corvino JK, Nich C, Carroll KM. Computerized Cognitive Behavioral Therapy for Substance Use Disorders in a Specialized Primary Care Practice: A Randomized Feasibility Trial to Address the RT Component of SBIRT. Journal Of Addiction Medicine 2020, 14: e303-e309. PMID: 32371660, DOI: 10.1097/adm.0000000000000663.Peer-Reviewed Original ResearchConceptsSubstance use disordersComputerized cognitive behavioral therapySubstance useCognitive behavioral therapySelf-reported substance useUse disordersTechnology-based treatmentsPrimary care settingSubstance use outcomesIntegrated addictions treatmentTechnology-based interventionsBehavioral therapyPrimary care practicesOverall positive outcomeSUD interventionsBrief interventionUnhealthy alcohol useDays abstinentPositive outcomesUse outcomesCare settingsAlcohol useStandard careAddiction treatmentTreatment settings
2017
Cost‐effectiveness of emergency department‐initiated treatment for opioid dependence
Busch SH, Fiellin DA, Chawarski MC, Owens PH, Pantalon MV, Hawk K, Bernstein SL, O'Connor PG, D'Onofrio G. Cost‐effectiveness of emergency department‐initiated treatment for opioid dependence. Addiction 2017, 112: 2002-2010. PMID: 28815789, PMCID: PMC5657503, DOI: 10.1111/add.13900.Peer-Reviewed Original ResearchConceptsCost-effectiveness acceptability curvesOpioid dependenceCommunity-based treatmentBrief interventionAcceptability curvesPast weekHealth care system costsHealth care system perspectiveAddiction treatmentOpioid-dependent patientsPatient time costsHealth care useFormal addiction treatmentBuprenorphine treatmentUrban EDEmergency departmentPrimary carePatient engagementTreatment engagementPatientsReferralSecondary analysisBuprenorphineNumber of daysInterventionEmergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention
D’Onofrio G, Chawarski MC, O’Connor P, Pantalon MV, Busch SH, Owens PH, Hawk K, Bernstein SL, Fiellin DA. Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention. Journal Of General Internal Medicine 2017, 32: 660-666. PMID: 28194688, PMCID: PMC5442013, DOI: 10.1007/s11606-017-3993-2.Peer-Reviewed Original ResearchConceptsIllicit opioid useOpioid usePrimary careHIV riskBrief interventionAddiction treatmentBuprenorphine groupEmergency Department-Initiated BuprenorphineCohort of patientsLong-term followLong-term outcomesFormal addiction treatmentSignificant differencesMain MeasuresSelfStudy entryUrine toxicologyBuprenorphine/Opioid dependenceED interventionsUrine resultsBuprenorphineTreatment engagementDrug useReferralPatients
2016
Protocol for three parallel multi-site stepped care effectiveness studies for unhealthy alcohol use in HIV-positive patients
Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Fiellin LE, O'Connor PG, Bedimo R, Gibert C, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Justice AC, Bryant KJ, Fiellin DA. Protocol for three parallel multi-site stepped care effectiveness studies for unhealthy alcohol use in HIV-positive patients. Contemporary Clinical Trials 2016, 52: 80-90. PMID: 27876616, PMCID: PMC5253227, DOI: 10.1016/j.cct.2016.11.008.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useAlcohol use disorderHIV-positive patientsMotivational enhancement therapyAlcohol useWeek 12Risk drinkingWeek 4Effective evidence-based treatmentsInfectious disease clinicHIV-positive individualsModerate alcohol useEvidence-based treatmentsParticipants meeting criteriaImplementation of interventionsVACS IndexHIV careSecondary outcomesCare trialsDisease clinicHIV morbidityPrimary outcomeAlcohol pharmacotherapyInitial treatmentLiver disease
2014
Primary Care–Based Buprenorphine Taper vs Maintenance Therapy for Prescription Opioid Dependence: A Randomized Clinical Trial
Fiellin DA, Schottenfeld RS, Cutter CJ, Moore BA, Barry DT, O’Connor P. Primary Care–Based Buprenorphine Taper vs Maintenance Therapy for Prescription Opioid Dependence: A Randomized Clinical Trial. JAMA Internal Medicine 2014, 174: 1947-1954. PMID: 25330017, PMCID: PMC6167926, DOI: 10.1001/jamainternmed.2014.5302.Peer-Reviewed Original ResearchConceptsPrescription opioid dependenceOngoing maintenance therapyIllicit opioid useMaintenance therapyOpioid dependenceBuprenorphine taperBuprenorphine therapyTaper groupMaintenance groupOpioid usePrimary careClinical trialsPrimary care-based treatmentSignificant public health burdenBuprenorphine maintenance therapyOngoing maintenance treatmentPrimary care physiciansEvidence-based guidelinesPrimary care sitesPublic health burdenWeeks of stabilizationHydrochloride therapyOpioid withdrawalBuprenorphine treatmentNaltrexone treatment
2013
Managing Substance Dependence as a Chronic Disease: Is the Glass Half Full or Half Empty?
O’Connor P. Managing Substance Dependence as a Chronic Disease: Is the Glass Half Full or Half Empty? JAMA 2013, 310: 1132-1134. PMID: 24045739, DOI: 10.1001/jama.2013.277610.Peer-Reviewed Original ResearchA Randomized Trial of Cognitive Behavioral Therapy in Primary Care-based Buprenorphine
Fiellin DA, Barry DT, Sullivan LE, Cutter CJ, Moore BA, O'Connor PG, Schottenfeld RS. A Randomized Trial of Cognitive Behavioral Therapy in Primary Care-based Buprenorphine. The American Journal Of Medicine 2013, 126: 74.e11-74.e17. PMID: 23260506, PMCID: PMC3621718, DOI: 10.1016/j.amjmed.2012.07.005.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyPhysician managementBehavioral therapyOpioid useOpioid dependencePrimary careSelf-reported frequencyBuprenorphine/naloxone treatmentConsecutive weeksOpioid-dependent patientsIllicit opioid usePrimary care clinicsPrimary outcome measureWeeks of treatmentNaloxone treatmentOpioid abstinenceBuprenorphine/Care clinicsIllicit opioidsRandomized trialsUrine toxicologyClinical trialsStudy completionOutcome measuresCocaine use
2012
Counseling and Directly Observed Medication for Primary Care Buprenorphine Maintenance
Moore BA, Barry DT, Sullivan LE, O'Connor PG, Cutter CJ, Schottenfeld RS, Fiellin DA. Counseling and Directly Observed Medication for Primary Care Buprenorphine Maintenance. Journal Of Addiction Medicine 2012, 6: 205-211. PMID: 22614936, PMCID: PMC3419276, DOI: 10.1097/adm.0b013e3182596492.Peer-Reviewed Original ResearchConceptsCognitive behavioral therapyPhysician managementObserved medicationBaseline characteristicsCBT sessionsOpioid-negative urinesIndividual CBT sessionsBuprenorphine maintenanceOpioid useMedication adherencePatient satisfactionPrimary careImproved outcomesTreatment outcomesSession attendanceNegative urineTreatment groupsGreater abstinenceCounseling intensityDrug useTherapist availabilityMedicationsBuprenorphinePatientsIndependent effects
2008
Integrating Buprenorphine Treatment into Office-based Practice: a Qualitative Study
Barry DT, Irwin KS, Jones ES, Becker WC, Tetrault JM, Sullivan LE, Hansen H, O’Connor P, Schottenfeld RS, Fiellin DA. Integrating Buprenorphine Treatment into Office-based Practice: a Qualitative Study. Journal Of General Internal Medicine 2008, 24: 218-225. PMID: 19089500, PMCID: PMC2628993, DOI: 10.1007/s11606-008-0881-9.Peer-Reviewed Original ResearchMeSH KeywordsBuprenorphineFamily PracticeFemaleHumansInterviews as TopicMaleOffice VisitsOpioid-Related DisordersPrimary Health CareQualitative ResearchConceptsBuprenorphine maintenance treatmentOffice-based practicePhysicians' perceptionsPatient-related barriersOffice-based physiciansLack of remunerationBuprenorphine treatmentOpioid dependenceMaintenance treatmentPhysician barriersMethadone maintenancePrimary careResultsEighty percentLow prevalenceClinical practiceMedical providersMultidisciplinary teamPatient careInternal medicinePhysician facilitatorsInfectious diseasesAddiction medicinePhysiciansQualitative software programDesignQualitative studyLong‐Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years
Fiellin DA, Moore BA, Sullivan LE, Becker WC, Pantalon MV, Chawarski MC, Barry DT, O'Connor PG, Schottenfeld RS. Long‐Term Treatment with Buprenorphine/Naloxone in Primary Care: Results at 2–5 Years. American Journal On Addictions 2008, 17: 116-120. PMID: 18393054, DOI: 10.1080/10550490701860971.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineCombined Modality TherapyCounselingCross-Sectional StudiesDose-Response Relationship, DrugDrug Administration ScheduleDrug Therapy, CombinationFemaleFollow-Up StudiesHeroin DependenceHumansLong-Term CareMaleMiddle AgedNaloxoneNarcotic AntagonistsOpioid-Related DisordersPatient DropoutsPrimary Health CareSubstance Abuse DetectionTreatment OutcomeConceptsOpioid-dependent patientsAdverse eventsSerum transaminasesBuprenorphine/naloxone treatmentSerious adverse eventsBuprenorphine/naloxoneLong-term outcomesOffice-based treatmentIllicit drug useOpioid useClinical stabilityNaloxone treatmentPrimary outcomePatient satisfactionPrimary careTerm treatmentDrug useUrine samplesPatientsTreatmentTransaminaseOutcomesYearsModerate levelsPercent
2007
Buprenorphine/naloxone treatment in primary care is associated with decreased human immunodeficiency virus risk behaviors
Sullivan LE, Moore BA, Chawarski MC, Pantalon MV, Barry D, O'Connor PG, Schottenfeld RS, Fiellin DA. Buprenorphine/naloxone treatment in primary care is associated with decreased human immunodeficiency virus risk behaviors. Journal Of Substance Use And Addiction Treatment 2007, 35: 87-92. PMID: 17933486, PMCID: PMC2587397, DOI: 10.1016/j.jsat.2007.08.004.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineFemaleHIV InfectionsHumansMaleMiddle AgedNaloxoneOpioid-Related DisordersPrimary Health CareRisk-TakingSexual BehaviorConceptsBuprenorphine/naloxone treatmentNaloxone treatmentHIV risk behaviorsHIV riskRisk behaviorsHuman immunodeficiency virus (HIV) risk behaviorsDrug-related HIV riskHuman immunodeficiency virus (HIV) riskSex-related HIV risk behaviorsBuprenorphine/naloxoneIntravenous drug useOpioid-dependent personsPrimary care clinicsInconsistent condom useBuprenorphine/Care clinicsMethadone treatmentPrimary careDrug useSteady partnerCondom useBaselineWeeksTreatmentPatientsPrimary Care Office-based Buprenorphine Treatment: Comparison of Heroin and Prescription Opioid Dependent Patients
Moore BA, Fiellin DA, Barry DT, Sullivan LE, Chawarski MC, O’Connor P, Schottenfeld RS. Primary Care Office-based Buprenorphine Treatment: Comparison of Heroin and Prescription Opioid Dependent Patients. Journal Of General Internal Medicine 2007, 22: 527-530. PMID: 17372805, PMCID: PMC1829433, DOI: 10.1007/s11606-007-0129-0.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnalgesics, OpioidBuprenorphineFemaleHeroinHeroin DependenceHumansMaleOffice VisitsOpioid-Related DisordersPrimary Health CareConceptsPrescription opioid useOpioid useOnly patientsPrescription opioidsTreatment outcomesBuprenorphine/naloxone maintenanceBuprenorphine/naloxone treatmentOpioid-negative urine samplesPrescription opioid-dependent patientsHepatitis C antibodyDrug treatment historyOpioid-dependent patientsPrimary care officesOffice-based settingClinical characteristicsBuprenorphine treatmentNaloxone treatmentBuprenorphine/Opioid dependenceCare officesDependent patientsTreatment responseC antibodyHeroin usePatientsPatient Satisfaction with Primary Care Office-Based Buprenorphine/Naloxone Treatment
Barry DT, Moore BA, Pantalon MV, Chawarski MC, Sullivan LE, O’Connor P, Schottenfeld RS, Fiellin DA. Patient Satisfaction with Primary Care Office-Based Buprenorphine/Naloxone Treatment. Journal Of General Internal Medicine 2007, 22: 242-245. PMID: 17356993, PMCID: PMC1824745, DOI: 10.1007/s11606-006-0050-y.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineFemaleHumansMaleMiddle AgedNaloxoneOffice VisitsOpioid-Related DisordersPatient SatisfactionPrimary Health CareTreatment OutcomeConceptsBuprenorphine/naloxonePatient satisfactionBuprenorphine/naloxone treatmentDrug treatment historyOpioid-dependent patientsPrimary care officesOpioid-dependent subjectsSubstance use statusOverall satisfaction scoreOffice visit frequencyNaloxone treatmentParticipantsOne hundredPrimary outcomeCare officesFemale genderTreatment historyPatientsNaloxoneSatisfaction scoresEthnicity/raceTreatment locationUse statusVisit frequencyMedicationsTreatment
2006
A Randomized Trial of Primary Intensive Care to Reduce Hospital Admissions in Patients with High Utilization of Inpatient Services
Sledge WH, Brown KE, Levine JM, Fiellin DA, Chawarski M, White WD, O'Connor PG. A Randomized Trial of Primary Intensive Care to Reduce Hospital Admissions in Patients with High Utilization of Inpatient Services. Population Health Management 2006, 9: 328-338. PMID: 17115880, DOI: 10.1089/dis.2006.9.328.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overCritical CareDelivery of Health CareFemaleFollow-Up StudiesHospitalizationHumansMaleMiddle AgedPrimary Health CareConceptsHospital admissionIntensive careFunctional statusInpatient servicesHealth outcomesUrban primary care clinicFrequent hospital admissionsEmergency department visitsMedication Adherence ScalePrimary care patientsPrimary care clinicsHealth care useRandomized clinical trialsOverall functional statusCase management interventionComprehensive multidisciplinary assessmentNumber of admissionsMental health functionPIC patientsUsual careClinic visitsCare patientsControlled TrialsDepartment visitsCare clinicsAre Commonly Ordered Lab Tests Useful Screens for Alcohol Disorders in Older Male Veterans Receiving Primary Care?
Reid MC, Guo Z, Van Ness PH, O'Connor PG, Concato J. Are Commonly Ordered Lab Tests Useful Screens for Alcohol Disorders in Older Male Veterans Receiving Primary Care? Substance Abuse 2006, 26: 25-32. PMID: 16687367, DOI: 10.1300/j465v26n02_04.Peer-Reviewed Original ResearchConceptsAST/ALT ratioAlcohol abuse/dependenceMean corpuscular volumeOlder male veteransAbuse/dependenceAlcohol Use Disorders Identification TestCAGE positivityRisk drinkingAlanine aminotransferaseALT ratioAspartate aminotransferaseAlcohol disordersMale veteransPrimary careMedical recordsParticipants' medical recordsAbnormal test resultsTest performance characteristicsDisorders Identification TestPositive likelihood ratioNegative likelihood ratioLikelihood ratioRoutine careVA databasesCAGE questionnaire
2005
Primary Intensive Care: Pilot Study of a Primary CareBased Intervention for High-Utilizing Patients
Brown KE, Levine JM, Fiellin DA, O'connor P, Sledge WH. Primary Intensive Care: Pilot Study of a Primary CareBased Intervention for High-Utilizing Patients. Population Health Management 2005, 8: 169-177. PMID: 15966782, DOI: 10.1089/dis.2005.8.169.Peer-Reviewed Original ResearchConceptsPilot studyHospital cost differencesWeekly multidisciplinary clinicHigher healthcare utilizationPrimary care patientsEmergency department usePrimary care centersPresence of psychopathologyManagement patientsCare patientsHealthcare utilizationMultidisciplinary clinicIntensive careDepartment useCare centerInpatient servicesPatientsPsychiatric diagnosisSpecial interventionStaff satisfactionStatistical significanceInterventionClinicCost differencesDiagnosisProblem Drinkers: Find Them, Keep Them, Don't Lose Them—Treat Them
O'Connor PG. Problem Drinkers: Find Them, Keep Them, Don't Lose Them—Treat Them. Journal Of General Internal Medicine 2005, 20: 96-97. PMID: 15693936, PMCID: PMC1490046, DOI: 10.1111/j.1525-1497.2005.04005.x.Peer-Reviewed Original Research
2004
Processes of Care During a Randomized Trial of Office‐based Treatment of Opioid Dependence in Primary Care
Fiellin DA, O'Connor PG, Chawarski M, Schottenfeld RS. Processes of Care During a Randomized Trial of Office‐based Treatment of Opioid Dependence in Primary Care. American Journal On Addictions 2004, 13: s67-s78. PMID: 15204676, DOI: 10.1080/10550490490440843.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultFemaleFocus GroupsHumansMaleMedical AuditMethadoneMiddle AgedMulticenter Studies as TopicNarcoticsOffice VisitsOpioid-Related DisordersOutcome and Process Assessment, Health CarePrimary Health CareProcess Assessment, Health CareQuality Assurance, Health CareRandomized Controlled Trials as TopicReferral and ConsultationSubstance Abuse DetectionTreatment RefusalUnited StatesConceptsUrine toxicology resultsProcess of careOpioid dependenceChart auditToxicology resultsOpioid treatment programsOffice-based careOffice-based treatmentDependent patientsMethadone maintenancePrimary carePsychiatric servicesFocus groupsQuality careTreatment programCareTreatmentTrialsAuditMedicationsBuprenorphinePatientsMethadoneGroupEvaluation of processes
2003
Initial and Maintenance Naltrexone Treatment for Alcohol Dependence Using Primary Care vs Specialty Care: A Nested Sequence of 3 Randomized Trials
O'Malley SS, Rounsaville BJ, Farren C, Namkoong K, Wu R, Robinson J, O'Connor PG. Initial and Maintenance Naltrexone Treatment for Alcohol Dependence Using Primary Care vs Specialty Care: A Nested Sequence of 3 Randomized Trials. JAMA Internal Medicine 2003, 163: 1695-1704. PMID: 12885685, DOI: 10.1001/archinte.163.14.1695.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAlanine TransaminaseAlcoholismAspartate AminotransferasesCognitive Behavioral TherapyCombined Modality TherapyConnecticutFemaleGamma-GlutamyltransferaseHumansMaleMedicineMiddle AgedNaltrexoneNarcotic AntagonistsPatient CompliancePatient ParticipationPrimary Health CareSpecializationTimeTreatment OutcomeConceptsPrimary care managementCognitive behavior therapyPlacebo-controlled studyAlcohol dependenceNaltrexone treatmentPersistent heavy drinkingPrimary care treatmentWeeks of treatmentMaintenance of responseMaintenance of improvementCBT armCBT patientsPlacebo groupNaltrexone maintenanceRandomized trialsCare treatmentPrimary careSpecialty carePCM patientsDays abstinentNaltrexoneInitial courseCare managementCBT respondersPatients