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OBJECTIVE: The goal of this study was to understand prevalence of co-occurring opioid use disorder and willingness to engage in treatment among clients of 8 Los Angeles County Department of Mental Health outpatient clinics. METHODS: Adults presenting for an appointment over a 2-week period were asked if they would like to complete an anonymous health survey. Clients who indicated opioid use in the past year were offered a longer survey which assessed probable opioid use disorder. Willingness to take a medication and receive any treatment also were assessed. RESULTS: 3,090 clients completed screening. 8% had a probable prescription (Rx) opioid use disorder; 2% had a probable heroin use disorder. 52% with Rx opioid use disorder were female compared to 30% with heroin use disorder. Of those with Rx opioid use disorder, 43% were Black, 33% were Hispanic and 12% were White; of those with heroin use disorder 24% were Black, 22% were Hispanic, and 39% were White. Those with Rx opioid use disorder were less familiar with medications for opioid use disorder than those with heroin use disorder (81% and 45%, respectively), and less likely to have received treatment (22% and 41%, respectively) and to have taken medication (18% and 41%, respectively). The strongest predictor of willingness to take a medication was believing that it would help stop opioid use (β=13.54, p

Introduction Studies showing sustained improvements in the delivery of clinical preventive services are limited. Fewer studies demonstrate sustained improvements among independent practices that are not affiliated with hospitals or integrated health systems. This study examines the continued improvement in clinical quality measures for a group of independent primary care practices using electronic health records (EHRs) and receiving technical support from a local public health agency. Methods We analyzed clinical quality measure performance data from a cohort of primary care practices that implemented an EHR at least 3 months before October 2009, the study baseline. We assessed trends for 4 key quality measures: antithrombotic therapy, blood pressure control, smoking cessation intervention, and hemoglobin A1c (HbA1c) testing based on monthly summary data transmitted by the practices. Results Of the 151 practices, 140 were small practices and 11 were community health centers; average time using an EHR was 13.7 months at baseline. From October 2009 through October 2011, average rates increased for antithrombotic therapy (from 58.4% to 74.8%), blood pressure control (from 55.3% to 64.1%), HbA1c testing (from 46.4% to 57.7%), and smoking cessation intervention (from 29.3% to 46.2%). All improvements were significant. Conclusion During 2 years, practices showed significant improvement in the delivery of several key clinical preventive services after implementing EHRs and receiving support services from a public health agency.