A prospective,multisite implementation-efficacy trial of a collaborative prescriber-pharmacist model of care for Medication Assisted Treatment for Opioid Dependence: Protocol for the EPIC-MATOD study |
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| Affiliation: | 1. Monash Addiction Research Centre, Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, Victoria, Australia;2. Frankston Mornington Peninsula Primary Care Partnership, Peninsula Health, Australia;3. Centre for Medicine Use and Safety (CMUS), Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia;4. Pharmacotherapy Mediation, Advocacy, and Support (PAMS), Harm Reduction Victoria, Australia;5. Centre for Health Economics, Monash Business School, Caulfield East, Victoria, Australia;6. Monash Health Drug and Alcohol Service, Monash Health, Melbourne, Victoria, Australia;1. School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Private Bag 26, Hobart, Tasmania, 7001, Australia;2. Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Private Bag 34, Hobart, Tasmania, 7001, Australia;3. Royal Hobart Hospital, GPO Box 1061, Hobart, Tasmania, 7001, Australia;1. UPMC Centers for High-Value Health Care and Value-Based Pharmacy Initiatives, UPMC Health Plan, Pittsburgh, PA, USA;2. Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA, USA;3. Evernorth Holding Company, St. Louis, MO, USA;4. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA;1. Palmerston North Hospital Pharmacy, MidCentral District Health Board, Palmerston North, New Zealand;2. School of Pharmacy, University of Otago, Dunedin, New Zealand;3. New Zealand Pharmacovigilance Centre, University of Otago, Dunedin, New Zealand;1. Department of Clinical Pharmacy, University of California San Francisco (UCSF), USA;2. Medication Outcomes Center, University of California San Francisco (UCSF), USA;3. Philip R. Lee Institute for Health Policy Studies at the University of California San Francisco (UCSF), USA;4. Department of Pharmaceutical Services, University of California San Francisco (UCSF) Medical Center, USA;1. Phymedexp, University of Montpellier, Inserm, CNRS, CHRU de Montpellier, 191 Avenue du Doyen Giraud, 34295, Montpellier cedex 5, France;2. Research Center on Aging, CIUSSS de l’Estrie-CHUS, 1036 Rue Belvédère Sud, Sherbrooke, Québec, J1H 4C4, Canada;3. Faculty of Pharmacy, University of Montreal, C.P. 6128, succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada;4. Department of Pharmacy, McGill University Health Centre, 1001 Boulevard Décarie, Montréal, Québec, H4A 3J1, Canada;5. Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12 Ave N Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada;6. Department of Medicine, CIUSSS de l’Estrie-CHUS, 3001 12e Avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada;7. Faculty of Letters and Human Sciences, University of Sherbrooke, 2500 Boulevard de l’Université, Sherbrooke, Québec, J1K 2R1, Canada;8. Faculty of Pharmacy, Laval University, 1050 Avenue de la Médecine, Québec, G1V 0A6, Canada;9. Department of Pharmacy, CIUSSS de l’Estrie-CHUS, 3001 12e Avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada |
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| Abstract: | BackgroundMedication Assisted Treatment for Opioid Dependence (MATOD) is clinically effective and cost effective, yet a lack of MATOD prescribers in the community limits access to this treatment in Australia. These shortages are often greatest in regional and rural areas.Objective(s)The Enhancing Pharmacist Involvement in Care (EPIC)-MATOD study will evaluate clinical and implementation outcomes among people with opioid dependence receiving MATOD through a collaborative pharmacist-prescriber model of care across multiple sites in a regional location (encompassing a mix of metropolitan and non-metropolitan areas) of Victoria, Australia.Methods and analysisThe EPIC-MATOD study is a prospective, multisite, implementation trial of collaborative MATOD care. Pharmacists and prescribers will be recruited through the local network of opioid pharmacotherapy providers. Patients will be recruited through participating healthcare providers. After induction into the collaborative care model, patients and healthcare professionals will be followed up over 6- (patients) and 12-months (pharmacists and prescribers) in a hybrid implementation-efficacy study, with outcomes mapped to the RE-AIM framework. The primary clinical efficacy endpoint is patient retention in treatment at 26 weeks. The primary implementation outcome is treatment capacity, based on prescriber time required to provide treatment through collaborative care compared with traditional care. Secondary clinical endpoints include attendance for dosing and clinical reviews, substance use, mental and physical health and overall well-being. Implementation costs, acceptability, and provider engagement in collaborative care will be used as secondary implementation outcome indicators. Time and costs associated with collaborative care, and health service utilisation, will also be estimated.Project impactThe study will provide important information on outcomes and acceptability of collaborative care for MATOD, as well as the cost and key considerations in delivering a collaborative model of care in Australia and other countries where similar treatment barriers exist. |
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| Keywords: | Opioid agonist treatment Community pharmacy Collaborative care Implementation-efficiency trial Study protocol MOUD |
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