1. Facilitation and Preferred Models for Delivering Substance Use Disorder Treatment in HIV Clinics: Results From a Multisite Randomized Trial.
- Author
-
Muvvala SB, Gan G, Morford KL, Dziura J, Esserman D, Porter E, Chan PA, Cornman DH, Reynolds J, Yager JE, Fiellin DA, and Edelman EJ
- Subjects
- Humans, New England, Alcoholism, Behavior, Addictive, Opioid-Related Disorders, HIV Infections
- Abstract
Background: Integrated addiction treatment in HIV clinics is associated with improved outcomes, yet it is offered inconsistently and with variable models of care. We sought to evaluate the impact of Implementation Facilitation ("Facilitation") on clinician and staff preference for provision of addiction treatment in HIV clinics with on-site resources (all trained or designated on-site specialist) versus outside resources (outside specialist or refer out)., Methods: From July 2017 to July 2020, surveys assessed clinician and staff preferences for addiction treatment models during control (ie, baseline), intervention, evaluation, and maintenance phases in 4 HIV clinics in the Northeast United States., Results: During the control phase, among 76 respondents (response rate, 58%), the proportions who preferred treatment with on-site resources for opioid use disorder (OUD), alcohol use disorder (AUD), and tobacco use disorder (TUD) were 63%, 55%, and 63%, respectively. Compared with control, there were no significant differences in preferred model during the intervention and evaluation phases except for AUD where there was an increased preference for treatment with on-site resources in the intervention versus control phase. Compared with control, during the maintenance phase, a higher proportion of clinicians and staff preferred providing addiction treatment with on-site resources versus outside resources: OUD, 75% (odds ratio [OR; 95% confidence interval {CI}], 1.79 [1.06-3.03]); AUD, 73% (OR [95% CI], 2.23 [1.36-3.65]), and TUD, 76% (OR [95% CI], 1.88 [1.11-3.18])., Conclusions: The findings from this study lend support for "Facilitation" as a strategy to enhance clinician and staff preference for integrated addiction treatment in HIV clinics with on-site resources., Competing Interests: Dr Muvvala reported receiving personal fees from Alkermes for participating in an advisory board meeting in 2020 outside the submitted work. Dr Chan is also on staff at the Rhode Island Department of Health and the Rhode Island Public Health Institute; to the best of the authors' knowledge, there are no existing additional conflicts of interest, financial or otherwise., (Copyright © 2023 American Society of Addiction Medicine.)
- Published
- 2023
- Full Text
- View/download PDF