Clinical trial NCT06291090: A Multi-site Intervention to Expand Hospital Based OUD Treatment Provision
Official title: In Hospital Treatment of Opioid Use Disorder: Clinician Perspectives and Current Practices
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Opioid Use Disorder
Keywords: opioid use disorder
hospital
Lead sponsor: University of Colorado, Denver
Sponsor class: OTHER
Collaborators: name: National Institute on Drug Abuse (NIDA)
First posted: 2024-03-04
Enrollment: 400
Sex: ALL
Minimum age (years): 18
Maximum age (years): 99
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: This intervention will be implemented across 12 hospitals
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The investigators implemented a multi-site hospital-based opioid use disorder (OUD) treatment intervention across 12 hospitals in Colorado to address an OUD treatment gap among hospitalized adults with OUD.

Detailed description: The investigators implemented a multi-site hospital-based opioid use disorder (OUD) treatment intervention across 12 hospitals in Colorado to address an OUD treatment gap among hospitalized adults with OUD. The intervention included nurse driven universal screening for unhealthy substance use with a social work referral for a brief intervention when indicted, electronic health record-embedded protocols to assess for opioid withdrawal and to direct buprenorphine initiation, methadone orders for opioid withdrawal symptoms, and embedded links for post discharge addiction treatment referral. It also included clinician education and nursing education via video conference or in-person lectures. The intervention was supported by the health system Chief Medical Officer and involved subject matters expertise and representation from nursing leaders, social work leaders, and hospital medicine leaders. Outcomes assess include a pre/post implementation assessment of 1) change in buprenorphine prescribed in hospital and 2) discharge, 3) change in naloxone prescribed, 4) change in hospital based methadone prescribing, and 5) change in average clinical opioid withdrawal scale (COWS) score. investigators also assessed a pre/post survey of hospitalists physicians and advanced practice providers to assess their perception of hospital based OUD treatment provision.

Eligibility criteria: Inclusion Criteria:

* Physicians, advanced practice providers, social workers, and nurses who work at any affiliated hospitals

Exclusion Criteria:

* none

Primary outcomes:
measure: Change in buprenorphine prescribing at hospital discharge
timeFrame: Calculate monthly prescribing rates over a three year time frame (including pre and post implementation) to assess for change
Secondary outcomes:
measure: Change in rates of methadone prescribing during hospitalization
timeFrame: Calculate monthly prescribing rates over a three year time frame (including pre and post implementation) to assess for change
Other outcomes:
measure: Change in average (mean) COWS score over time
timeFrame: Calculate mean monthly COWS scores over a three year time frame (including pre and post implementation) to assess for change
measure: Change in naloxone prescribing at hospital discharge
timeFrame: Calculate monthly prescribing rates over a three year time frame (including pre and post implementation) to assess for change
Locations:
city: Aurora
country: United States
facility: University of Colorado Anschutz Medicl Campus
state: Colorado
Study officials:
affiliation: University of Colorado, Denver
name: Susan L Calcaterra, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Calcaterra SL, Lockhart S, Natvig C, Mikulich S. Barriers to initiate buprenorphine and methadone for opioid use disorder treatment with postdischarge treatment linkage. J Hosp Med. 2023 Oct;18(10):896-907. doi: 10.1002/jhm.13193. Epub 2023 Aug 22.