The purpose of this trial is to test the efficacy of a collaborative care intervention to address opioid- and/or stimulant-involved polysubstance use in adult primary care patients with moderate to severe substance use disorders (SUD). The primary aims are to reduce days of opioid use (illicit or nonmedical opioid use), days of illicit stimulant use (cocaine, methamphetamine), and days of heavy alcohol use.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
301
All PCPs in the EUC and Co-Care arms receive brief education on SUD treatment, including medications for OUD and AUD and contingency management for StUD, and recognizing and counteracting stigma while caring for patients with SUD.
A full-time clinic-embedded nurse care manager who works with patients and their PCPs to facilitate and support patient engagement in evidence-based treatment for polysubstance use and management of associated health conditions
An addiction specialist consultant who supports the nurse care manager and PCP in formulating and adjusting treatment plans
Harbor-UCLA Medical Center
Torrance, California, United States
NYU Langone Health
New York, New York, United States
The Institute for Family Health
New York, New York, United States
Winding Waters Medical Clinic
Enterprise, Oregon, United States
Total days of use of opioids, stimulants, and alcohol heavy drinking
Days of opioid use are defined as days with any use of heroin or synthetic opioids, or nonmedical use of prescription opioids. Nonmedical use includes using prescription opioids more than prescribed (e.g., taking two tablets when the prescription indicates a dose of one tablet) or taking pharmaceutical opioids that were not prescribed to the individual taking them. Days of stimulant use are defined as days with any use of cocaine or methamphetamine. Days of alcohol heavy drinking are defined as days with 5+ drinks/day for men, 4+ drinks/day for women. This outcome measure is collected using single item questions based on the Addiction Severity Index. Patient participants are asked to specify the number of days of use in the past 30 days (range is 0-30 days, value=0 for substances that were not used). The assessment is self-administered using a computerized form.
Time frame: Month 4-6
Treatment Effectiveness Assessment (TEA) total score
The Treatment Effectiveness Assessment (TEA) is a 4-item patient-reported outcome measure of progress in treatment and recovery in the four following domains: substance use, health, lifestyle, and community involvement. Each domain is assessed with a single item and scored on a scale of 1-10 (higher scores indicate better progress). The total score is calculated using the sum of numerical responses for the four domains and can range from four (not well at all on all domains) to 40 (extremely well on all domains).
Time frame: Baseline
Treatment Effectiveness Assessment (TEA) total score
The Treatment Effectiveness Assessment (TEA) is a 4-item patient-reported outcome measure of progress in treatment and recovery in the four following domains: substance use, health, lifestyle, and community involvement. Each domain is assessed with a single item and scored on a scale of 1-10 (higher scores indicate better progress). The total score is calculated using the sum of numerical responses for the four domains and can range from four (not well at all on all domains) to 40 (extremely well on all domains).
Time frame: Month 3
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Health coaches who use motivational interviewing and cognitive behavioral therapy to motivate and support patients in behavior change to reduce polysubstance use-related harms. Patients may receive up to 12 health coaching sessions in total. The sessions will occur via phone and/or HIPAA compliant video chat software.
Patient participants receive an educational pamphlet addressing overdose prevention, information about accessing naloxone, and local SUD treatment options.
Union Community Care
Lancaster, Pennsylvania, United States
Harris Health
Houston, Texas, United States
Sea Mar Community Health Centers
Bellingham, Washington, United States
Wisconsin Research & Education Network
Madison, Wisconsin, United States
Treatment Effectiveness Assessment (TEA) total score
The Treatment Effectiveness Assessment (TEA) is a 4-item patient-reported outcome measure of progress in treatment and recovery in the four following domains: substance use, health, lifestyle, and community involvement. Each domain is assessed with a single item and scored on a scale of 1-10 (higher scores indicate better progress). The total score is calculated using the sum of numerical responses for the four domains and can range from four (not well at all on all domains) to 40 (extremely well on all domains).
Time frame: Month 6
Treatment Effectiveness Assessment (TEA) total score
The Treatment Effectiveness Assessment (TEA) is a 4-item patient-reported outcome measure of progress in treatment and recovery in the four following domains: substance use, health, lifestyle, and community involvement. Each domain is assessed with a single item and scored on a scale of 1-10 (higher scores indicate better progress). The total score is calculated using the sum of numerical responses for the four domains and can range from four (not well at all on all domains) to 40 (extremely well on all domains).
Time frame: Month 12
Total days of use of opioids, stimulants, and alcohol
Days of opioid use are defined as days with any use of heroin or synthetic opioids, or nonmedical use of prescription opioids. Nonmedical use includes using prescription opioids more than prescribed (e.g., taking two tablets when the prescription indicates a dose of one tablet) or taking pharmaceutical opioids that were not prescribed to the individual taking them. Days of stimulant use are defined as days with any use of cocaine or methamphetamine. Days of alcohol heavy drinking are defined as days with 5+ drinks/day for men, 4+ drinks/day for women. This outcome measure is collected using single item questions based on the Addiction Severity Index. Patient participants are asked to specify the number of days of use in the past 30 days (range is 0-30 days, value=0 for substances that were not used). The assessment is self-administered using a computerized form.
Time frame: Months 10-12
Average days of abstinence from any unhealthy use of opioids, stimulants, and alcohol
Days of abstinence from substances of concern is measured as part of the Addiction Severity Index. At the end of the substance specific questions, patient participants who reported use of more than one substance of concern will be asked: "On how many days did you use none of these \[insert names of all substances with 1+ days of use reported\]?" (range is 0-30 days). For participants reporting use of 0-1 substances of concern, days of abstinence is calculated as 30 minus \[number of days reported\].
Time frame: Month 6
Average days of abstinence from any unhealthy use of opioids, stimulants, and alcohol
Days of abstinence from substances of concern is measured as part of the Addiction Severity Index. At the end of the substance specific questions, patient participants who reported use of more than one substance of concern will be asked: "On how many days did you use none of these \[insert names of all substances with 1+ days of use reported\]?" (range is 0-30 days). For participants reporting use of 0-1 substances of concern, days of abstinence is calculated as 30 minus \[number of days reported\].
Time frame: Month 12
Number of days of nonmedical benzodiazepine use
Nonmedical benzodiazepine use is defined as taking benzodiazepines that were not prescribed to the individual taking them. This outcome measure will be measured using single item questions based on the Addiction Severity Index. "During the past 30 days, on how many days did you use \[substance name\]?" The question will be asked separately for each substance type. Patient participants are asked to specify the number of days of use in the past 30 days (range is 0-30 days, value=0 for substances that were not used). The assessment is self-administered using a computerized form.
Time frame: Baseline
Number of days of nonmedical benzodiazepine use
Nonmedical benzodiazepine use is defined as taking benzodiazepines that were not prescribed to the individual taking them. This outcome measure will be measured using single item questions based on the Addiction Severity Index. "During the past 30 days, on how many days did you use \[substance name\]?" The question will be asked separately for each substance type. Patient participants are asked to specify the number of days of use in the past 30 days (range is 0-30 days, value=0 for substances that were not used). The assessment is self-administered using a computerized form.
Time frame: Months 4-6
Number of days of nonmedical benzodiazepine use
Nonmedical benzodiazepine use is defined as taking benzodiazepines that were not prescribed to the individual taking them. This outcome measure will be measured using single item questions based on the Addiction Severity Index. "During the past 30 days, on how many days did you use \[substance name\]?" The question will be asked separately for each substance type. Patient participants are asked to specify the number of days of use in the past 30 days (range is 0-30 days, value=0 for substances that were not used). The assessment is self-administered using a computerized form.
Time frame: Months 10-12
Proportion of patients with receipt of a prescription for a medication used for SUD treatment
Medication for SUD is defined as any medication for OUD, AUD, or StUD. This measures is collected from the electronic health record.
Time frame: Baseline
Proportion of patients with receipt of a prescription for a medication used for SUD treatment
Medication for SUD is defined as any medication for OUD, AUD, or StUD. This measures is collected from the electronic health record.
Time frame: Month 3
Proportion of patients with receipt of a prescription for a medication used for SUD treatment
Medication for SUD is defined as any medication for OUD, AUD, or StUD. This measures is collected from the electronic health record.
Time frame: Month 6
Proportion of patients with receipt of a prescription for a medication used for SUD treatment
Medication for SUD is defined as any medication for OUD, AUD, or StUD. This measures is collected from the electronic health record.
Time frame: Month 12
Proportion of patients attending behavioral health visit(s) addressing substance use
This measure is based on behavioral health visits addressing substance use that occurred in the study clinic(s), as documented in the electronic health record.
Time frame: Baseline
Proportion of patients attending behavioral health visit(s) addressing substance use
This measure is based on behavioral health visits addressing substance use that occurred in the study clinic(s), as documented in the electronic health record.
Time frame: Month 3
Proportion of patients attending behavioral health visit(s) addressing substance use
This measure is based on behavioral health visits addressing substance use that occurred in the study clinic(s), as documented in the electronic health record.
Time frame: Month 6
Proportion of patients attending behavioral health visit(s) addressing substance use
This measure is based on behavioral health visits addressing substance use that occurred in the study clinic(s), as documented in the electronic health record.
Time frame: Month 12
OUD symptom score from the Modified World Mental Health Composite International Diagnostic Interview (CIDI) questionnaire
The CIDI questionnaire measures severity of symptoms for three categories of substance use disorders (SUD); OUD, StUD, and AUD. The OUD category in the questionnaire is comprised of 15 yes/no items. The OUD symptom score is calculated by finding the sum of the items marked "Yes". OUD scores are interpreted as follows: 0-1 (subthreshold), 2-3 (mild use disorder), 4-5 (moderate use disorder), and 6+ (severe use disorder).
Time frame: Baseline
OUD symptom score from the Modified World Mental Health Composite International Diagnostic Interview (CIDI) questionnaire
The CIDI questionnaire measures severity of symptoms for three categories of substance use disorders (SUD); OUD, StUD, and AUD. The OUD category in the questionnaire is comprised of 15 yes/no items. The OUD symptom score is calculated by finding the sum of the items marked "Yes". OUD scores are interpreted as follows: 0-1 (subthreshold), 2-3 (mild use disorder), 4-5 (moderate use disorder), and 6+ (severe use disorder).
Time frame: Month 6
StUD symptom score from the Modified World Mental Health Composite International Diagnostic Interview (CIDI) questionnaire
The CIDI questionnaire measures severity of symptoms for three categories of substance use disorders (SUD); OUD, StUD, and AUD. The StUD category in the questionnaire is comprised of 15 yes/no items. The StUD symptom score is calculated by finding the sum of the items marked "Yes". StUD scores are interpreted as follows: 0-1 (subthreshold), 2-3 (mild use disorder), 4-5 (moderate use disorder), and 6+ (severe use disorder).
Time frame: Baseline
StUD symptom score from the Modified World Mental Health Composite International Diagnostic Interview (CIDI) questionnaire
The CIDI questionnaire measures severity of symptoms for three categories of substance use disorders (SUD); OUD, StUD, and AUD. The StUD category in the questionnaire is comprised of 15 yes/no items. The StUD symptom score is calculated by finding the sum of the items marked "Yes". StUD scores are interpreted as follows: 0-1 (subthreshold), 2-3 (mild use disorder), 4-5 (moderate use disorder), and 6+ (severe use disorder).
Time frame: Month 6
AUD symptom score from the Modified World Mental Health Composite International Diagnostic Interview (CIDI) questionnaire
The CIDI questionnaire measures severity of symptoms for three categories of substance use disorders (SUD); OUD, StUD, and AUD. The AUD category in the questionnaire is comprised of 15 yes/no items. The AUD symptom score is calculated by finding the sum of the items marked "Yes". AUD scores are interpreted as follows: 0-1 (subthreshold), 2-3 (mild use disorder), 4-5 (moderate use disorder), and 6+ (severe use disorder).
Time frame: Baseline
AUD symptom score from the Modified World Mental Health Composite International Diagnostic Interview (CIDI) questionnaire
The CIDI questionnaire measures severity of symptoms for three categories of substance use disorders (SUD); OUD, StUD, and AUD. The AUD category in the questionnaire is comprised of 15 yes/no items. The AUD symptom score is calculated by finding the sum of the items marked "Yes". AUD scores are interpreted as follows: 0-1 (subthreshold), 2-3 (mild use disorder), 4-5 (moderate use disorder), and 6+ (severe use disorder).
Time frame: Month 6
Overdose Risk Behavior Questionnaire score
The Overdose Risk Behavior Questionnaire is a 9-item self-administered questionnaire. These questions measure the frequency, in the past 6 months, at which individuals used alone; used in a new place/environment; used other substances (alcohol, benzodiazepines, stimulants) within 2 hours of opioids; used more than one opioid; used more than the usual amount; and used inhaled or injected opioids. Response options were "never (0)," "rarely (1)," "sometimes (2)," "often (3)," and "very often (4)," except for #6, which was "never (0)," "once (1)," or "more than once (2)." The total risk score is an aggregation of responses to the individual questions. Sum score range: 0-32, higher scores indicate greater risk of overdose.
Time frame: Baseline
Overdose Risk Behavior Questionnaire score
The Overdose Risk Behavior Questionnaire is a 9-item self-administered questionnaire. These questions measure the frequency, in the past 6 months, at which individuals used alone; used in a new place/environment; used other substances (alcohol, benzodiazepines, stimulants) within 2 hours of opioids; used more than one opioid; used more than the usual amount; and used inhaled or injected opioids. Response options were "never (0)," "rarely (1)," "sometimes (2)," "often (3)," and "very often (4)," except for #6, which was "never (0)," "once (1)," or "more than once (2)." The total risk score is an aggregation of responses to the individual questions. Sum score range: 0-32, higher scores indicate greater risk of overdose.
Time frame: Month 6
Overdose Risk Behavior Questionnaire score
The Overdose Risk Behavior Questionnaire is a 9-item self-administered questionnaire. These questions measure the frequency, in the past 6 months, at which individuals used alone; used in a new place/environment; used other substances (alcohol, benzodiazepines, stimulants) within 2 hours of opioids; used more than one opioid; used more than the usual amount; and used inhaled or injected opioids. Response options were "never (0)," "rarely (1)," "sometimes (2)," "often (3)," and "very often (4)," except for #6, which was "never (0)," "once (1)," or "more than once (2)." The total risk score is an aggregation of responses to the individual questions. Sum score range: 0-32, higher scores indicate greater risk of overdose.
Time frame: Month 12
Number of episodes of a non-fatal overdose
Outcome measure is self reported on the Non-Fatal Overdose Questionnaire.
Time frame: Baseline
Number of episodes of a non-fatal overdose
Outcome measure is self reported on the Non-Fatal Overdose Questionnaire.
Time frame: Month 6
Number of episodes of a non-fatal overdose
Outcome measure is self reported on the Non-Fatal Overdose Questionnaire.
Time frame: Month 12
World Health Organization Quality of Life (WHOQOL-BREF) score
The WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health (7 items), psychological health (6 items), social relationships (3 items), and environmental health (8 items); it also contains QOL and general health items. The mean score of items within each domain is used to calculate the domain score. After computed the scores, they transformed linearly to a 0-100-scale. Higher scores denote higher QOL.
Time frame: Baseline
World Health Organization Quality of Life (WHOQOL-BREF) score
The WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health (7 items), psychological health (6 items), social relationships (3 items), and environmental health (8 items); it also contains QOL and general health items. The mean score of items within each domain is used to calculate the domain score. After computed the scores, they transformed linearly to a 0-100-scale. Higher scores denote higher QOL.
Time frame: Month 3
World Health Organization Quality of Life (WHOQOL-BREF) score
The WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health (7 items), psychological health (6 items), social relationships (3 items), and environmental health (8 items); it also contains QOL and general health items. The mean score of items within each domain is used to calculate the domain score. After computed the scores, they transformed linearly to a 0-100-scale. Higher scores denote higher QOL.
Time frame: Month 6
World Health Organization Quality of Life (WHOQOL-BREF) score
The WHOQOL-BREF is a 26-item instrument consisting of four domains: physical health (7 items), psychological health (6 items), social relationships (3 items), and environmental health (8 items); it also contains QOL and general health items. The mean score of items within each domain is used to calculate the domain score. After computed the scores, they transformed linearly to a 0-100-scale. Higher scores denote higher QOL.
Time frame: Month 12
Single-item general health question (HRQOL-1) score
Questionnaire consist of one question 'Would you say that in general your health is' \[scaled response ranges from (5)Excellent, (4)Very good, (3)Good, (2)Fair or (1)Poor\]. The higher the score the better the patient's general health.
Time frame: Baseline
Single-item general health question (HRQOL-1) score
Questionnaire consist of one question 'Would you say that in general your health is' \[scaled response ranges from (5)Excellent, (4)Very good, (3)Good, (2)Fair or (1)Poor\]. The higher the score the better the patient's general health.
Time frame: Month 3
Single-item general health question (HRQOL-1) score
Questionnaire consist of one question 'Would you say that in general your health is' \[scaled response ranges from (5)Excellent, (4)Very good, (3)Good, (2)Fair or (1)Poor\]. The higher the score the better the patient's general health.
Time frame: Month 6
Single-item general health question (HRQOL-1) score
Questionnaire consist of one question 'Would you say that in general your health is' \[scaled response ranges from (5)Excellent, (4)Very good, (3)Good, (2)Fair or (1)Poor\]. The higher the score the better the patient's general health.
Time frame: Month 12
Patient Health Questionnaire (PHQ-8) score
The Patient Health Questionnaire depression scale (PHQ-8) consists of 8 items. The scores for each item are summed to produce a total score between 0 and 24 points. A total score of 0 to 4 represents no significant depressive symptoms. A total score of 5 to 9 represents mild depressive symptoms; 10 to 14, moderate; 15 to 19, moderately severe; and 20 to 24, severe.
Time frame: Baseline
Patient Health Questionnaire (PHQ-8) score
The Patient Health Questionnaire depression scale (PHQ-8) consists of 8 items. The scores for each item are summed to produce a total score between 0 and 24 points. A total score of 0 to 4 represents no significant depressive symptoms. A total score of 5 to 9 represents mild depressive symptoms; 10 to 14, moderate; 15 to 19, moderately severe; and 20 to 24, severe.
Time frame: Month 3
Patient Health Questionnaire (PHQ-8) score
The Patient Health Questionnaire depression scale (PHQ-8) consists of 8 items. The scores for each item are summed to produce a total score between 0 and 24 points. A total score of 0 to 4 represents no significant depressive symptoms. A total score of 5 to 9 represents mild depressive symptoms; 10 to 14, moderate; 15 to 19, moderately severe; and 20 to 24, severe.
Time frame: Month 6
Patient Health Questionnaire (PHQ-8) score
The Patient Health Questionnaire depression scale (PHQ-8) consists of 8 items. The scores for each item are summed to produce a total score between 0 and 24 points. A total score of 0 to 4 represents no significant depressive symptoms. A total score of 5 to 9 represents mild depressive symptoms; 10 to 14, moderate; 15 to 19, moderately severe; and 20 to 24, severe.
Time frame: Month 12
Percentage of participants with a negative suicidality screen
Outcome measured by Ask Suicide-Screening Questions (ASQ). The ASQ consists of four yes/no questions. If patient answers "No" to all questions 1 through 4, they are considered negative for suicidality. If patient answers "Yes" to any of questions 1 through 4, or refuses to answer, they are considered a positive screen.
Time frame: Baseline
Percentage of participants with a negative suicidality screen
Outcome measured by Ask Suicide-Screening Questions (ASQ). The ASQ consists of four yes/no questions. If patient answers "No" to all questions 1 through 4, they are considered negative for suicidality. If patient answers "Yes" to any of questions 1 through 4, or refuses to answer, they are considered a positive screen.
Time frame: Month 3
Percentage of participants with a negative suicidality screen
Outcome measured by Ask Suicide-Screening Questions (ASQ). The ASQ consists of four yes/no questions. If patient answers "No" to all questions 1 through 4, they are considered negative for suicidality. If patient answers "Yes" to any of questions 1 through 4, or refuses to answer, they are considered a positive screen.
Time frame: Month 6
Percentage of participants with a negative suicidality screen
Outcome measured by Ask Suicide-Screening Questions (ASQ). The ASQ consists of four yes/no questions. If patient answers "No" to all questions 1 through 4, they are considered negative for suicidality. If patient answers "Yes" to any of questions 1 through 4, or refuses to answer, they are considered a positive screen.
Time frame: Month 12
Generalized Anxiety Disorder (GAD-7) score
The Generalized Anxiety Disorder Assessment (GAD-7) is a seven-item instrument that is used to measure or assess the severity of generalized anxiety disorder (GAD). The whole scale score can range from 0 to 21 Score 5-9: Mild Anxiety. Score 10-14: Moderate Anxiety. Score greater than 15: Severe Anxiety.
Time frame: Baseline
Generalized Anxiety Disorder (GAD-7) score
The Generalized Anxiety Disorder Assessment (GAD-7) is a seven-item instrument that is used to measure or assess the severity of generalized anxiety disorder (GAD). The whole scale score can range from 0 to 21 Score 5-9: Mild Anxiety. Score 10-14: Moderate Anxiety. Score greater than 15: Severe Anxiety.
Time frame: Month 3
Generalized Anxiety Disorder (GAD-7) score
The Generalized Anxiety Disorder Assessment (GAD-7) is a seven-item instrument that is used to measure or assess the severity of generalized anxiety disorder (GAD). The whole scale score can range from 0 to 21 Score 5-9: Mild Anxiety. Score 10-14: Moderate Anxiety. Score greater than 15: Severe Anxiety.
Time frame: Month 6
Generalized Anxiety Disorder (GAD-7) score
The Generalized Anxiety Disorder Assessment (GAD-7) is a seven-item instrument that is used to measure or assess the severity of generalized anxiety disorder (GAD). The whole scale score can range from 0 to 21 Score 5-9: Mild Anxiety. Score 10-14: Moderate Anxiety. Score greater than 15: Severe Anxiety.
Time frame: Month 12
Primary Care Post-Traumatic Disorder Screen for DSM-5 (PC-PTSD-5) score
PC-PTSD-5 consists of 5-items. If a respondent denies exposure, the PC-PTSD-5 is complete with a score of 0 meaning no trauma exposure. If a respondent endorses a trauma exposure, they can score a 0-5 on the PC-PTSD-5, which is a count of "yes" responses to the 5 questions about how the trauma has affected them in the past month. Higher scores indicate the trauma exposure has often affected them over the past month.
Time frame: Baseline
Primary Care Post-Traumatic Disorder Screen for DSM-5 (PC-PTSD-5) score
PC-PTSD-5 consists of 5-items. If a respondent denies exposure, the PC-PTSD-5 is complete with a score of 0 meaning no trauma exposure. If a respondent endorses a trauma exposure, they can score a 0-5 on the PC-PTSD-5, which is a count of "yes" responses to the 5 questions about how the trauma has affected them in the past month. Higher scores indicate the trauma exposure has often affected them over the past month.
Time frame: Month 3
Primary Care Post-Traumatic Disorder Screen for DSM-5 (PC-PTSD-5) score
PC-PTSD-5 consists of 5-items. If a respondent denies exposure, the PC-PTSD-5 is complete with a score of 0 meaning no trauma exposure. If a respondent endorses a trauma exposure, they can score a 0-5 on the PC-PTSD-5, which is a count of "yes" responses to the 5 questions about how the trauma has affected them in the past month. Higher scores indicate the trauma exposure has often affected them over the past month.
Time frame: Month 6
Primary Care Post-Traumatic Disorder Screen for DSM-5 (PC-PTSD-5) score
PC-PTSD-5 consists of 5-items. If a respondent denies exposure, the PC-PTSD-5 is complete with a score of 0 meaning no trauma exposure. If a respondent endorses a trauma exposure, they can score a 0-5 on the PC-PTSD-5, which is a count of "yes" responses to the 5 questions about how the trauma has affected them in the past month. Higher scores indicate the trauma exposure has often affected them over the past month.
Time frame: Month 12
Number of Patient Reported ED visits
Time frame: Baseline
Number of Patient Reported ED visits
Time frame: Month 6
Number of Patient Reported ED visits
Time frame: Month 12
Number of patient reported hospital admissions
Time frame: Baseline
Number of patient reported hospital admissions
Time frame: Month 6
Number of patient reported hospital admissions
Time frame: Month 12
Proportion of patients with a diagnosis of OUD receiving any medication for OUD treatment
Time frame: Month 12
Proportion of patients with a diagnosis of AUD receiving any medication for AUD treatment
Time frame: Month 12
PCPs Medical Condition Regard Scale (MCRS) score
Medical Condition Regard Scale (MCRS) is a self-administered instrument examines the degree to which 12 medical conditions (including alcohol dependence and intravenous drug use) are enjoyable, treatable, and worthy of medical resources. Responses were measured on a six-point Likert scale: 1 = strongly disagree, 2 = disagree, 3 = not sure but probably disagree, 4 = not sure but probably agree, 5 = agree, and 6 = strongly agree. A MCRS score of \>57 correlates with high probability of desire to care for patients with with drug and alcohol use.
Time frame: Baseline
PCPs Medical Condition Regard Scale (MCRS) score
Medical Condition Regard Scale (MCRS) is a self-administered instrument examines the degree to which 12 medical conditions (including alcohol dependence and intravenous drug use) are enjoyable, treatable, and worthy of medical resources. Responses were measured on a six-point Likert scale: 1 = strongly disagree, 2 = disagree, 3 = not sure but probably disagree, 4 = not sure but probably agree, 5 = agree, and 6 = strongly agree. A MCRS score of \>57 correlates with high probability of desire to care for patients with with drug and alcohol use.
Time frame: End of intervention period, up to 21 months
PCPs REDUCE-HARM instrument score
The REDUCE-HARM instrument is a 24-item scale to measure healthcare professional attitudes to work with people who inject drugs including self-reported skills in different aspects of substance use as well as attitudes towards individuals who use drugs. Each item is ranked from 1 = not at all important to 3 = very important. Higher scores indicate positive attitudes toward caring for patients with SUD.
Time frame: Baseline
PCPs REDUCE-HARM instrument score
The REDUCE-HARM instrument is a 24-item scale to measure healthcare professional attitudes to work with people who inject drugs including self-reported skills in different aspects of substance use as well as attitudes towards individuals who use drugs. Each item is ranked from 1 = not at all important to 3 = very important. Higher scores indicate positive attitudes toward caring for patients with SUD.
Time frame: End of intervention period, up to 21 months
PCPs Addictions Knowledge Questions score
The Addictions Knowledge Questions is a 6-question measure that asks basic knowledge questions about DSM-criteria for SUD, and pharmacological treatments for OUD and AUD. Each item is answered by the PCP with a choice of "Correct" or "Incorrect". The score is calculated by the adding the number of items that are answered with "Correct". Total scores range from 0-6, a higher score indicating better knowledge.
Time frame: Baseline
PCPs Addictions Knowledge Questions score
The Addictions Knowledge Questions is a 6-question measure that asks basic knowledge questions about DSM-criteria for SUD, and pharmacological treatments for OUD and AUD. Each item is answered by the PCP with a choice of "Correct" or "Incorrect". The score is calculated by the adding the number of items that are answered with "Correct". Total scores range from 0-6, a higher score indicating better knowledge.
Time frame: End of intervention period, up to 21 months