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Wait No Longer: Reducing Medication Wait-Times for Individuals with Co-Occurring Disorders
James H Ford1, Deepika Rao1, Aaron Gilson1
1School of Pharmacy - Social and Administrative Sciences Division, University of Wisconsin - Madison, Madison, Wisconsin, USA.
Journal of Dual Diagnosis
|April 7, 2022
Summary
The Network for the Improvement of Addiction Treatment (NIATx) strategy reduced wait times for addiction medications and integrated treatments for co-occurring disorders (COD). However, improvements were delayed, highlighting the need for faster medication access in addiction care.
Area of Science:
- Addiction Medicine and Treatment
- Implementation Science
- Public Health
Background:
- Community addiction treatment agencies use the Network for the Improvement of Addiction Treatment (NIATx) to reduce appointment wait times.
- The impact of NIATx on medication access wait times, particularly for individuals with co-occurring disorders (COD), remains under-explored.
- Reducing wait times for medication is crucial for effective and timely treatment initiation.
Purpose of the Study:
- To evaluate the effectiveness of NIATx implementation strategies in reducing wait times for addiction, psychotropic, or both medications.
- To analyze the impact on individuals with co-occurring disorders (COD) receiving integrated treatment.
- To explore the timing and extent of wait-time reductions associated with the NIATx intervention.
Main Methods:
- A cluster-randomized waitlist control trial involving 49 community addiction treatment agencies.
- Agencies were randomized to receive the NIATx strategy (Cohort 1) or serve as a waitlist control (Cohort 2) over a 12-month intervention period.
- Medication encounter wait-time was the primary outcome, analyzed using a univariate general linear model with logarithmic transformation.
Main Results:
- The NIATx strategy significantly reduced wait times for psychotropic and combined addiction/psychotropic medications, with improvements observed between Baseline/Year 1 and Year 2.
- Wait-time reductions for addiction medications were significant over time but not necessarily due to the intervention alone.
- Wait-time reductions in the NIATx group were delayed, occurring in the sustainment phase, with average decreases of 3 days (psychotropic), 4.9 days (addiction), and 6.8 days (both medications).
Conclusions:
- NIATx implementation strategies effectively reduced medication encounter wait-times for individuals with COD, though the timing of improvements varied.
- Wait times for psychotropic, addiction, or both medications decreased by 3, 4.9, and 6.8 days respectively in the intervention group.
- A three-week wait time for integrated pharmacological interventions remains suboptimal, necessitating further efforts by agencies to eliminate barriers and improve immediate medication access.
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