PRP028: Association of ECHO participation on expanding buprenorphine treatment for opioid use disorder in rural primary care
Julie Salvador, PhD
Context: Access to medications for opioid use disorders (MOUD) is limited, especially for rural communities in New Mexico. Documented barriers limit integration of treatment for opioid use disorder (OUD) using FDA approved medications in primary care settings, inhibiting provider training and delivery of treatment. Innovative delivery mechanisms to enhance integration of services. Objective: Examine impact of participation in the Extensions for Community Healthcare Outcomes model (ECHO) intervention on expansion of OUD treatment using buprenorphine among rural primary care providers. Study Design: Quasi-experimental, pretest-posttest design along with mixed method evaluation to assess achievement of benchmark measures related to MAT integration. Inferential statistics examine the association between participation in ECHO sessions on expansion of MOUD treatment. Setting: Rural outpatient primary care providers in New Mexico and surrounding rural border area states including Medical Doctors, Doctors of Osteopathic Medicine, Nurse Practitioners, and Physician Assistants. Population Studied: Eligible participants are providers who have not received a DATA-waiver to prescribe buprenorphine or those that have a waiver but have treated fewer than 30 patients within six months of enrollment. Intervention/Instrument: A 12-session curriculum designed to provide education, support and consultation focusing on key areas to help start, expand and sustain MAT for OUD in rural primary care. It includes details on prescribing, psychosocial treatment, recovery support, and clinic functioning. In addition, if the provider does not achieve study benchmarks every three months support is provided outside of the ECHO and documented. Outcome Measures: Primary outcome measures are the following implementation benchmarks: 1) obtaining DATA 2000 waiver, 2) obtaining license X number, 3) prescribing buprenorphine to first patient, 4) adding additional patients onto provider’s buprenorphine panel. Outcomes to be reported: Current results from inferential analyses demonstrate a trend toward a positive relationship between participation in the ECHO and expansion of MOUD treatment. Thirty-eight clinics have enrolled into the study, and 29 have provided follow-up data for at least one time point. Approximately two-thirds (65%) have accomplished at least one of the benchmarks toward expanding MAT, and nearly half (48%) have started prescribing buprenorphine to more than one patient.