Clinical trial NCT04867382: Comparing Two Training Methods for Opioid Wizard
Official title: Reducing Stigma Toward People With Opioid Use Disorder Among Primary Care Clinicians
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Opioid-use Disorder
Opioid Dependence
Attitude of Health Personnel
Lead sponsor: HealthPartners Institute
Sponsor class: OTHER
Collaborators: name: Hennepin Healthcare Research Institute
name: National Institute on Drug Abuse (NIDA)
First posted: 2021-04-30
Enrollment: 88
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: This study used a randomized controlled trial (RCT) design embedded in a larger, multisite trial of a clinical decision support (CDS) tool to help PCCs identify, diagnose, and treat patients with OUD. PCCs in clinics randomized to Opioid Wizard were randomized 1:1 to the intervention or comparison training and stratified by clinic.
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The prevalence of opioid use disorder (OUD) and opioid-related deaths has risen dramatically in recent years. Effective treatments, including medications for opioid use disorder (MOUDs; e.g., buprenorphine-naloxone and methadone) are under-utilized. There are few evidence-based interventions for changing attitudes toward Opioid Use Disorder (OUD) in the general public and especially among healthcare clinicians. This study proposed an innovative intervention to change attitudes of Primary Care Clinicians (PCCs) toward persons with OUD. Study participants were stratified into one of two online learning courses: the intervention training was compared with an attention-control training.

Detailed description: Primary care offers an ideal setting in which to treat OUD; however, few clinicians are waivered to prescribe buprenorphine and of those who are waivered, less than one-third do prescribe. One potential barrier to increasing access to MOUDs are primary care clinician (PCC) attitudes towards people with OUD.

This study used a randomized controlled trial design to examine a novel intervention to change attitudes towards people with OUD among PCCs. PCCs in clinics randomized to the intervention in COMPUTE 2.0 (PCCs in 15 of the 30 clinics randomized in the parent study) were randomized 1:1 to the intervention or comparison training, stratified by clinic and waiver status. Training was conducted via MyLearning, an online learning software. All PCCs were asked to complete a brief training (25-35 minutes for both trainings) on the shared decision-making tool (SDM) called the Opioid Wizard, which alerts PCCs to screen, diagnose, and treat people with OUD. PCCs in the intervention arm heard patient narratives designed to shift attitudes about patients with OUD. PCCs in the comparison training had training on using the SDM tool. The PCCs were asked to complete a survey of attitudes and intentions to get waivered to prescribe buprenorphine immediately following the online training. Use of the CDS was monitored in both groups for 6 months.

Eligibility criteria: Inclusion Criteria:

* Primary Care Clinician: Had to be a family physician, general internist, adult-care non-obstetric nurse practitioner, or a physician assistant
* Had to practice at a study-eligible primary care clinic already involved in the main study intervention arm

Exclusion Criteria:

PCCs were ineligible to participate if they had fewer than 5 eligible patient encounters between Sep 2020 and Feb 2021.

Primary outcomes:
measure: Difference, Disdain, and Blame Scales
timeFrame: Immediately after completing online training.
Secondary outcomes:
measure: Intentions to Get Waivered to Prescribe Buprenorphine.
timeFrame: Immediately after completing online training
measure: Intentions to Prescribe Buprenorphine Should a Waiver no Longer be Required.
timeFrame: Immediately after completing online training
measure: Opioid Wizard Use
timeFrame: Six months following online training.
Other outcomes:
Locations:
city: Bloomington
country: United States
facility: HealthPartners
state: Minnesota
Study officials:
affiliation: HealthPartners Institute
name: Stephanie Hooker, PhD, MPH, MS
role: PRINCIPAL_INVESTIGATOR
References: