2024
Strategies to Deimplement Opioid Prescribing in Primary Care
Quanbeck A, Robinson J, Jacobson N, Li X, Hennessy-Garza R, Landeck J, Cohen A, Madden L, Pulvermacher A, Brown R. Strategies to Deimplement Opioid Prescribing in Primary Care. JAMA Network Open 2024, 7: e2438325. PMID: 39388183, DOI: 10.1001/jamanetworkopen.2024.38325.Peer-Reviewed Original ResearchConceptsCluster randomized clinical trialDeimplementation strategiesMorphine milligram equivalent doseMorphine milligram equivalentsPractice facilitationOpioid prescribingIncreased screeningTreatment agreementsUS health care systemCenters for Disease Control and Prevention guidelinesRandomized clinical trialsUrine drug screensPrimary care clinicsPrimary care settingPrimary outcomeMental health screeningPain-related interferenceHealth care systemHigh-intensity groupEnjoyment of lifeChronic pain managementPrimary careCare clinicsCare settingsHealth screeningDesign and implementation of a Type-2 hybrid, prospective randomized trial of opioid agonist therapies integration into primary care clinics in Ukraine
Machavariani E, Dumchev K, Pykalo I, Filippovych M, Ivasiy R, Esserman D, Madden L, Bromberg D, Haddad M, Morozova O, Ahmad B, Gómez D, Farnum S, Dvoriak S, Altice F. Design and implementation of a Type-2 hybrid, prospective randomized trial of opioid agonist therapies integration into primary care clinics in Ukraine. Contemporary Clinical Trials 2024, 146: 107690. PMID: 39265780, PMCID: PMC11531372, DOI: 10.1016/j.cct.2024.107690.Peer-Reviewed Original ResearchPrimary care centersQuality health indicatorsNon-communicable diseasesSpecialty treatment centersOpioid agonist therapyImplementation of integrated carePay-for-performance incentivesPrimary care clinicsPrimary care settingSelf-reported prevalencePay-for-performancePrevalence of medical comorbiditiesParticipants self-reportedEffective evidence-based treatmentsHealth of PWIDEvidence-based treatmentsIntegrated careCare clinicsImplementation outcomesImplementation trialCare settingsElectronic chart reviewHigh-burden countriesSpecialty servicesHIV prevalenceIntegrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge
Bromberg D, Machavariani E, Madden L, Dumchev K, LaMonaca K, Earnshaw V, Pykalo I, Filippovych M, Haddad M, Dvoriak S, Altice F. Integrating methadone into primary care settings in Ukraine: effects on provider stigma and knowledge. Journal Of The International AIDS Society 2024, 27: e26202. PMID: 38379179, PMCID: PMC10879646, DOI: 10.1002/jia2.26202.Peer-Reviewed Original ResearchConceptsPrimary care clinicsStigma reduction interventionsOpioid agonist therapyClinicians' attitudesStigma constructsHIV preventionReduction interventionsEvidence-based HIV preventionCluster randomized controlled trialEvidence-based carePrimary care settingIntegrated care sitesDirect providersRandomized controlled trialsProvider stigmaCare clinicsCare sitesHIV careCare settingsHealth outcomesClinical staffSubstance use disordersLinear mixed-effects modelsTreatment continuumImprove attitudes
2021
Primary care and medication management characteristics among patients receiving office-based opioid treatment with buprenorphine
Du CX, Shi J, Tetrault JM, Madden LM, Barry DT. Primary care and medication management characteristics among patients receiving office-based opioid treatment with buprenorphine. Family Practice 2021, 39: 234-240. PMID: 34893825, PMCID: PMC8947790, DOI: 10.1093/fampra/cmab166.Peer-Reviewed Original ResearchConceptsOffice-based opioid treatmentPrimary care providersOpioid use disorderUrine toxicologyOpioid treatmentMore primary care providersOutpatient primary care clinicsChronic pain statusChronic viral hepatitisPrimary care clinicsCommon comorbid conditionsPrimary care characteristicsAddiction treatment settingsHigher median numberEvidence-based treatment modelsOBOT patientsOBOT programOlder patientsPain statusViral hepatitisCommon medicationsRetrospective reviewCare clinicsChronic painComorbid conditionsSuccessful transfer of stable patients on opioid agonist therapies from specialty addiction treatment to primary care settings in Ukraine: A pilot study
Meteliuk A, Galvez S, Fomenko T, Kalandiia H, Iaryi V, Farnum SO, Islam Z, Altice FL, Madden LM. Successful transfer of stable patients on opioid agonist therapies from specialty addiction treatment to primary care settings in Ukraine: A pilot study. Journal Of Substance Use And Addiction Treatment 2021, 134: 108619. PMID: 34579978, DOI: 10.1016/j.jsat.2021.108619.Peer-Reviewed Original ResearchConceptsOpioid agonist therapyPrimary care clinicsPrimary care settingOAT coverageAgonist therapyStable patientsCare clinicsSubstance useCare settingsNegative urine drug testsSpecialty addictions treatmentUrine drug testsSymptom Identification ScaleMental health symptomsAddiction treatment clinicsHIV transmissionPrimary careTreatment clinicsOAT patientsBASIS-24PatientsHealth symptomsEmotional labilityAddiction treatmentPilot study
2020
The Balanced Opioid Initiative: protocol for a clustered, sequential, multiple-assignment randomized trial to construct an adaptive implementation strategy to improve guideline-concordant opioid prescribing in primary care
Quanbeck A, Almirall D, Jacobson N, Brown RT, Landeck JK, Madden L, Cohen A, Deyo BMF, Robinson J, Johnson RA, Schumacher N. The Balanced Opioid Initiative: protocol for a clustered, sequential, multiple-assignment randomized trial to construct an adaptive implementation strategy to improve guideline-concordant opioid prescribing in primary care. Implementation Science 2020, 15: 26. PMID: 32334632, PMCID: PMC7183389, DOI: 10.1186/s13012-020-00990-4.Peer-Reviewed Original ResearchConceptsOpioid prescribing practicesPrimary care clinicsPractice facilitationPrescribing practicesPrimary careOpioid prescribingMonth 3Primary outcomeCare clinicsDifferent primary care clinicsDiverse primary care clinicsHybrid type 3Study's primary outcomeDifferent clinical settingsPrimary aimCost-effective sequenceOpioid misuseEvidence-based practiceMonth 21Study's primary aimClinical guidelinesImplementation strategiesOverdose deathsDesignThe studyAdaptive implementation strategy
2018
A randomized matched-pairs study of feasibility, acceptability, and effectiveness of systems consultation: a novel implementation strategy for adopting clinical guidelines for Opioid prescribing in primary care
Quanbeck A, Brown RT, Zgierska AE, Jacobson N, Robinson JM, Johnson RA, Deyo BM, Madden L, Tuan WJ, Alagoz E. A randomized matched-pairs study of feasibility, acceptability, and effectiveness of systems consultation: a novel implementation strategy for adopting clinical guidelines for Opioid prescribing in primary care. Implementation Science 2018, 13: 21. PMID: 29370813, PMCID: PMC5784593, DOI: 10.1186/s13012-018-0713-1.Peer-Reviewed Original ResearchMeSH KeywordsAnalgesics, OpioidChronic PainDelivery of Health CareEvidence-Based PracticeFemaleFocus GroupsGuideline AdherenceHumansInterviews as TopicMaleOpioid-Related DisordersPractice Guidelines as TopicPractice Patterns, Physicians'Primary Health CareQualitative ResearchReferral and ConsultationResearch DesignConceptsOpioid prescribingIntervention clinicsClinical guidelinesPrimary careMorphine equivalent daily doseSafe opioid prescribingPercentage of patientsPrimary care clinicsMental health screenUrine drug testsRE-AIM frameworkDiscrete implementation strategiesMatched-pair studyInnovative implementation strategyDaily doseCare clinicsChronic painAcademic detailingTreatment agreementsHealth screenChronic conditionsImplementation strategiesOpioid abuseControl clinicsMixed-method evaluation