Primary Care Addiction Consultation Service: Colorado’s Implementation Support for Medication for Opioid Use Disorder (MOUD)

<h3>Context</h3> Drug-related overdose and death in the US continue to rise. Primary care practices are often the first location a patient seeks treatment for substance use disorder (SUD). Addiction medicine consult services have emerged to help address the shortage in access to SUD treatment. This intervention used a primary care addiction consultation service model including education, an addiction medicine consultant, and practice facilitation to increase capacity for opioid use disorder (OUD) treatment. <h3>Objective</h3> This presentation describes evaluation findings from a yearlong, multicomponent intervention to increase primary care practice capacity to offer Medication for Opioid Use Disorder (MOUD). <h3>Study Design and Analysis</h3> Evaluation of intervention. Data sources include quarterly ratings of milestone progress and monthly semi-structured field notes documenting practice interactions. We used the Wilcoxon signed rank test to compare number of buprenorphine prescriptions and milestone implementation before and after intervention participation. <h3>Setting or Dataset</h3> Twenty-two Colorado primary care practices of varying organizational structure participated from 2022 through 2024. <h3>Population Studied</h3> Primary care practice teams. <h3>Intervention/Instrument</h3> Practices received education, practice facilitation and peer-to-peer consultation support from an addiction medicine physician. <h3>Outcome Measures</h3> Number of buprenorphine prescriptions; practice-reported ratings of implementation of MOUD-related milestones. <h3>Results</h3> Practice types included clinician-owned, FQHCs, and system-owned; most specialized in family medicine (91%, N=22). Practices reported significant increases in buprenorphine prescribing and implementation of MOUD milestones. Among the 22 participating practices, the mean number of patients prescribed buprenorphine increased from 1.5 per clinic (SD=6.4) at baseline to 8.5 (SD=10.2, p&lt;.001) at program completion (9-12 months). Ratings of implementation for core aim 1) Build your team increased from an average of 35% complete at baseline to 94% complete (p&lt;.001); implementation ratings for core aim 2) Engage and support patients increased from 24% to 85% (p&lt;.001); and ratings of implementation for core aim 3) Connect with recovery support services increased from 25% to 91% (p&lt;.001). <h3>Conclusions</h3> This primary care addiction consultation model illustrates how education and support to clinical teams can help practices change implementation and behavior related to MOUD.