Using a Learning Collaborative Strategy With Office-based Practices to Increase Access and Improve Quality of Care...

Area of Science:

• Public Health
• Medical Education
• Health Services Research

Background:

• Opioid use disorder (OUD) is a significant public health crisis, particularly in rural areas.
• Access to Food and Drug Administration-approved medications for OUD, such as buprenorphine, remains limited.
• Physician practice patterns for prescribing buprenorphine vary widely, impacting patient care.

Purpose of the Study:

• To evaluate the effectiveness of a learning collaborative model in enhancing buprenorphine provision for OUD.
• To improve physician engagement and reduce practice variation in buprenorphine prescribing.
• To assess the impact on patient access to medication-assisted treatment.

Main Methods:

• A 9-month learning collaborative involving 28 physician practices across 4 cohorts.
• Utilized a blend of face-to-face and teleconference sessions.
• Tracked 8 quality-improvement measures, including patient numbers and follow-up frequency, analyzing changes using p-charts and logistic regression.

Main Results:

• High physician engagement (85.7%) was observed across all cohorts.
• Statistically significant improvements were noted in 4 out of 7 quality-improvement measures (P < 0.001).
• Practice variation decreased across all measures, though the increase in patients receiving medication was modest (3.4%).

Conclusions:

• The learning collaborative model effectively engages physicians in improving OUD treatment.
• This approach significantly reduces practice variation and modestly improves patient access to buprenorphine.
• The strategy shows potential for broader application in regions facing similar public health challenges.