Colorado

"Implementing Technology and Medication-Assisted Team Training and Treatment in Rural Colorado (IT MATTTRs Colorado)," University of Colorado, Denver.

Key Lessons Learned in Medication-Assisted Treatment Implementation

  • Obtaining Drug Enforcement Administration (DEA) Waiver:
    • Providers experience a lag, or hesitation, between acquiring a MAT Drug Enforcement Administration (DEA) waiver and actually providing MAT in primary care.
    • Prescriber waiver training is a necessary but insufficient strategy to increase access to MAT for OUD in rural primary care practices.
  • Training Providers:
    • Primary care practice teams are interested in learning more about opioid use disorder and medication assisted treatment, as supported by the number of practices recruited (42, goal of 40), many of which did not have a waivered prescriber at the time of training. 
    • A team-based training increases knowledge and improves positive attitudes towards MAT across different roles (provider, clinical staff, and administrative staff).
    • Implementing MAT programs requires more time and resources than anticipated for some practices.  MAT implementation is not an all-or-nothing endeavor for many primary care practices.
  • Stigma: Team Training can help create an opportunity for practice team members to better understand opioid use disorder (OUD) and addiction and address stigma both in the community and practice.

Statistics

  • MAT Waivered Prescribers: Number of MAT prescribers in the study region has increased from three prior to the study to over 36.
  • Practice
    • Project delivered IT MATTTRs Practice Team Training to 42 practices and reached 441 practice team members (98 clinicians, 207 clinical support staff, 107 administrative support staff, and 29 others).
    • Response to curriculum is positive, across roles and in SOuND and ECHO participants. Average attendance is consistent between both SOuND and ECHO participants.
    • Overall, self-reported ability to deliver MAT improved significantly; however, significant differences occurred between SOuND and ECHO practices.
  • Community Knowledge, Attitudes, and Beliefs:
    • Survey distributed throughout study region before and after the development and distribution of community intervention messages and materials.
    • Community intervention successfully reached over half of the survey respondents despite a limited dissemination budget.
      • A greater percentage of respondents can identify local treatment for OUD resources in their community at follow-up than at baseline.
      • Respondents reported greater awareness of MAT, primary care, behavioral health, and outpatient treatment resources in their community at follow-up.
      • A substantial proportion of respondents reported knowing that opioids were an issue (ceiling effect) at baseline; however, improvement of opioid knowledge still occurred. 

Accomplishments

  • Successful recruitment of participating practices surpassed original recruitment goals.
  • The IT MATTTRs practice team training elicited high levels of satisfaction with the training curriculum and increased perceived self-efficacy. 
  • Preliminary evaluation suggest strong movement in practices with and without a waivered provider towards MAT engagement and delivery.
  • The community-created intervention successfully reached many community members in the study region, and the messages and materials had a positive impact on changing knowledge, attitudes, and beliefs around opioids.
  • An opportunity to leverage additional funding has allowed the project to offer team training and provider training across the State.

Conferences & Publications

Conference Date Location Type
Health Resources and Services Administration (HRSA) Behavioral Health Workgroup Behavioral Health/Opioids Peer Learning Team Meeting December 4-5, 2019 Rockville, MD Oral Presentation

North American Primary Care Research Group (NAPCRG) Annual Meeting

November 17-20, 2019 Toronto, Canada

Oral PresentationPoster

National Conference on Addiction Disorders (NCAD) West October 24-26, 2019 Denver, CO Oral Presentation
Consortium Provider Education Symposium October 23, 2019 Aurora, CO Poster
State Networks of Colorado Ambulatory Practices & Partners (SNOCAP) September 20-21, 2019 Lakewood, CO Oral Presentation
Medicaid Medical Directors Network Meeting September 17-18, 2019 Washington, DC Oral Presentation
Public Health in the Rockies Annual Conference (PHiR) August 28-30, 2019 Keystone, CO Oral Presentation Poster
International Conference on Practice Facilitation June 26-27, 2019 Bethesda, MD Oral Presentation
Practice Based Research Network (PBRN) Conference June 24-25, 2019 Bethesda, MD Oral Presentation
Colorado Opioid Safety Summit January 25, 2019 Lone Tree, CO Oral Presentation
North American Primary Care Research Group (NAPCRG) Annual Meeting November 9-13, 2018 Chicago, IL Poster
Engaging Communities in Education and Research September 21-23, 2018 Breckenridge, CO Oral Presentation Poster
PBRN Conference June 25-26, 2018 Bethesda, MD Poster
Public Health in the Rockies PHiR Annual Conference August 29-31, 2018 Copper Mountain, CO Oral Presentation Poster
Colorado Opioid Safety Summit January 25, 2018 Lone Tree, CO Poster
NAPCRG Annual Meeting November 17-21, 2017 Toronto, Canada Poster
State Networks of Colorado Ambulatory Practices & Partners (SNOCAP) September 22 - 23, 2017   Oral Presentation

Oral Presentation Oral Presentation    Poster Poster