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A randomized, parallel group, pragmatic comparative-effectiveness trial comparing medication-assisted treatment
Douglas H Fernald1, Donald E Nease1, John M Westfall2
1Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America.
Plos One
|September 8, 2023
Summary
This study compares office, home, and telehealth induction for medication for opioid use disorder (MOUD). It aims to find the best buprenorphine induction method for long-term treatment success and patient quality of life.
Area of Science:
- Public Health
- Clinical Medicine
- Pharmacology
Background:
- Opioid use disorder (OUD) is a major public health issue in the US.
- Medication for opioid use disorder (MOUD) with buprenorphine is an effective treatment.
- The induction method for MOUD may impact treatment outcomes.
Purpose of the Study:
- To compare short-term stabilization and long-term treatment engagement for MOUD using office, home, or telehealth induction.
- To identify factors associated with successful long-term MOUD treatment.
Main Methods:
- A randomized, parallel-group, pragmatic comparative effectiveness trial.
- 100 primary care practices in the US.
- Patients randomized to office, home, or telehealth buprenorphine induction.
Main Results:
- Primary outcomes include buprenorphine adherence and illicit opioid use at 30, 90, and 270 days.
- Secondary outcomes assess quality of life and treatment maintenance mediators.
- Analysis includes practice- and patient-level random effects.
Conclusions:
- This study addresses a gap in comparative effectiveness research for MOUD induction methods.
- Results will guide primary care providers in selecting optimal induction strategies for OUD patients.
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