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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
1,080
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
University of Arizona College of Medicine
Tucson, Arizona, United States
Days in Treatment to treatment interruption
Time (days) to treatment interruption
Time frame: 18 months
Time to treatment cessation
Time to treatment cessation (tolerance of 30 days)
Time frame: 18 months
In Treatment- Point in time
Point in time in treatment (0 day, 30 day, 60, day, 90 day)
Time frame: 18 months
Number of patients reporting opioid overdoses while in methadone treatment
Reported overdoses by patients in methadone treatment during the trial period by survey measured at 5 points during the study period.
Time frame: 18 months
Number of staff experiencing vicarious (work related) stress
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
Time frame: 18 months
Number of patients and staff experiencing post traumatic stress symptoms
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.
Time frame: 18 months
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