Opioid Use Disorder, Patients, Staff
Conditions
Keywords
Methadone
Brief summary
The trial of Methadone Patient Access to Collaborative Treatment (MPACT) will establish the impact of the intervention on patient outcomes of methadone treatment retention and in treatment overdose. It will also establish the impact of patient and staff trauma symptoms and clinic practice change on MPACT intervention implementation.
Detailed description
This MPACT trial will involve finalizing the refined MPACT intervention (materials, training) and conducting a Hybrid Type 1, 15-month cluster randomized controlled trial in 30 clinics with 600 patients (20/clinic) and 480 staff (18/clinic) to assess MPACT effect on patient outcomes and examine the relationship between staff trauma outcomes and MPACT implementation. R33 Specific AIMS: AIM 1: Quantify the effects of MPACT on methadone treatment (MMT) practice change and opioid treatment program (OTP) culture. AIM 2: Determine the efficacy of MPACT on MMT retention, in-MMT overdose and patient and staff post traumatic stress symptoms (PTSS) outcomes. AIM 3: Evaluate the effect of patient and staff trauma symptoms on primary outcomes and staff MPACT implementation.
Interventions
OTHERMPACT
Four components are part of this intervention: 1) accredited training about patient centered, trauma-informed care and the standard of care under the current federal regulation (42CFRpart8), 2) education about trauma and trauma symptoms including vicarious (work related) trauma and navigation to symptoms screening and resources including treatment, 3) reflective supervision for counseling, case management and peer staff, and 4) clinic self assessment for trauma-informed and patient centered care
Sponsors
University of Arizona
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Hybrid Type 1, 20-month simultaneous cluster randomized controlled trial in 36 clinics
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Staff providing methadone treatment services at the enrolled opioid treatment programs
Exclusion criteria
* Patients receiving methadone treatment at the enrolled opioid treatment programs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Days in Treatment to treatment interruption | 18 months | Time (days) to treatment interruption |
| Missed doses | 20 months | Missed methadone doses in the last 30 days |
| In Treatment- Point in time | 18 months | Point in time in treatment (0 day, 30 day, 60, day, 90 day) |
| Number of patients reporting opioid overdoses while in methadone treatment | 18 months | Reported overdoses by patients in methadone treatment during the trial period by survey measured at 5 points during the study period. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of staff experiencing vicarious (work related) stress | 18 months | Post traumatic stress symptoms and vicarious (work related) trauma symptoms measured by the Vicarious Trauma Scale (VTS). Total scores can be grouped into three categories to represent low (8-28), moderate (29-42) and high (43-56) levels of vicarious trauma symptoms |
| Number of patients and staff experiencing post traumatic stress symptoms | 18 months | Post traumatic stress symptoms measured by the 8-item PCL-5 measuring post traumatic stress symptoms. Scores range from 0-80, with higher scores representing greater levels of traumatic stress symptomatology. |
Countries
United States
Outcome results
None listed