Replication of an emergency department-based recovery coaching intervention and pilot testing of pragmatic trial protocols within the context of Indiana's Opioid State Targeted Response plan.

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  • Additional Information
    • Source:
      Publisher: Pergamon Press Country of Publication: United States NLM ID: 8500909 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-6483 (Electronic) Linking ISSN: 07405472 NLM ISO Abbreviation: J Subst Abuse Treat Subsets: MEDLINE
    • Publication Information:
      Original Publication: New York : Pergamon Press, c1984-
    • Subject Terms:
      Government Programs* ; Patient Selection*; Emergency Service, Hospital/*organization & administration ; Health Services Accessibility/*organization & administration ; Naloxone/*therapeutic use ; Opioid-Related Disorders/*drug therapy; Humans ; Indiana ; Peer Group ; Pilot Projects ; State Government
    • Abstract:
      Solving the opioid crisis requires immediate, innovative, and sustainable solutions. A number of promising strategies are being carried out by U.S. states and territories as part of their Opioid State Targeted Response (STR) plans funded through the 21st Century Cures Act, and they provide an opportunity for researchers to assess effectiveness of these interventions using pragmatic approaches. This paper describes a pilot study of Project Planned Outreach, Intervention, Naloxone, and Treatment (POINT), the intervention that served as the basis for Indiana's STR-funded, emergency department (ED)-based peer specialist expansion that was conducted in preparation for a larger, multisite pragmatic trial. Through the pilot, we identified, documented, and corrected for challenges encountered while implementing planned study protocols. Per the project's funding mechanism, the ability to move to the larger trial was determined by the achievement of 3 milestones: (1) successful replication of the intervention; (2) demonstrated ability to obtain the necessary sample size; and (3) observe a higher level of engagement in medication for addiction treatment in the POINT group compared to standard care. Overall implementation of the study protocols was successful, with only minor refinements to proposed procedures being required in light of challenges with (1) data access, (2) recruitment, and (3) identification of the expansion hospitals. All three milestones were reached. Challenges in implementing protocols and reaching milestones resulted in refinements that improved the study design overall. The subsequent trial will add to the limited but growing evidence on ED-based peer supports. Capitalizing on STR efforts to study an already scaling and promising intervention is likely to lead to faster and more sustainable results with greater generalizability than traditional, efficacy-focused clinical research.
      (Copyright © 2019 Elsevier Inc. All rights reserved.)
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    • Grant Information:
      R21 DA045850 United States DA NIDA NIH HHS; R33 DA045850 United States DA NIDA NIH HHS
    • Contributed Indexing:
      Keywords: 21st century cures; Medication for addiction treatment; Opioid State Targeted Response; Opioid use disorder; Peer support; Pilot study; Recovery coach; Social emergency medicine
    • Accession Number:
      36B82AMQ7N (Naloxone)
    • Publication Date:
      Date Created: 20190616 Date Completed: 20210315 Latest Revision: 20210315
    • Publication Date:
      20240628
    • Accession Number:
      PMC6893113
    • Accession Number:
      10.1016/j.jsat.2019.06.002
    • Accession Number:
      31200985