A Multi-site Intervention to Expand Hospital Based OUD Treatment Provision

Not Applicable

Recruiting

• Conditions: Opioid Use Disorder
• Interventions: Behavioral: OUD treatment intervention

• Registration Number: NCT06291090
• Lead Sponsor: University of Colorado, Denver

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.

Study Timeline

• Study Start: 2023-01-18
• Study First Submitted: 2024-02-20
• Study First Submitted QC: 2024-02-26
• Status Verified: 2024-03
• Study First Posted: 2024-03-04
• Last Update Submitted: 2024-03-27
• Last Update Posted: 2024-03-29
• Primary Completion: 2024-04-30
• Study Completion: 2025-05-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 400

Inclusion Criteria

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

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Exclusion Criteria

• none

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
OUD intervention	OUD treatment intervention	Participants received education on the diagnosis and management of OUD, have access to protocols to walk them through assessment of OUD using Diagnostic and Statistical Manual, fifth Edition (DSM)-5, COWS score to calculate severity of opioid withdrawal, buprenorphine or methadone initiation with pre-populated orders, and clickable links for OUD treatment referral post discharge.

Primary Outcome Measures

Name	Time	Method
Change in buprenorphine prescribing at hospital discharge	Calculate monthly prescribing rates over a three year time frame (including pre and post implementation) to assess for change	Change in rate of buprenorphine prescribing at hospital discharge among patients with OUD before and after intervention implementation

Secondary Outcome Measures

Name	Time	Method
Change in rates of methadone prescribing during hospitalization	Calculate monthly prescribing rates over a three year time frame (including pre and post implementation) to assess for change	Change in rate of in hospital methadone prescribing among patients with OUD before and after intervention implementation

Trial Locations

Locations (1)

University of Colorado Anschutz Medicl Campus; 🇺🇸 Aurora, Colorado, United States