Do Communities Implementing the Communities That HEAL Intervention Have Significantly Lower Rates of High-Risk Opioid...

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Prescription opioids pose risks for opioid use disorder and overdose.
• Improving prescription opioid safety is crucial for mitigating these risks.
• The Communities That HEAL (CTH) intervention aims to address these issues through community engagement and evidence-based practices.

Purpose of the Study:

• To evaluate the effectiveness of the CTH intervention in improving prescription opioid safety measures.
• To determine if communities randomized to the CTH intervention show significantly different rates of prescription opioid safety compared to control communities.

Main Methods:

• A multisite, cluster randomized, wait-list controlled trial involving 67 communities across four states.
• The CTH intervention included community engagement, evidence-based practices for opioid use disorder and prescription opioid safety, and communication campaigns.
• Outcomes included high-risk opioid prescribing, short-supply opioid prescriptions, and multi-provider/pharmacy use, assessed from July 2021 to June 2022.

Main Results:

• No statistically significant differences were observed in the rates of new incident high-risk opioid prescribing between CTH intervention communities and wait-list control communities (RR: 0.98, 95% CI: [0.93, 1.02]).
• Other assessed prescription opioid safety measures also showed no significant differences between the study arms.
• Both intervention and control groups demonstrated improvements in safety measures during the study period.

Conclusions:

• The CTH intervention did not yield statistically significant improvements in prescription opioid safety measures compared to the control group.
• Observed improvements in both arms suggest that broader contextual factors, such as revised clinical practice guidelines, may influence opioid prescribing trends.
• Further research may be needed to understand the impact of community-level interventions in conjunction with external guideline changes.