The University of Pittsburgh School of Pharmacy’s Program Evaluation and Research Unit (PERU) has received a five-year, $7.8 million grant from the National Institute on Drug Abuse to improve the quality of care for patients with opioid use disorder across the Pennsylvania.
The project will establish the Center for Long-Term Cessation Assistance (HEALing) at Pitt, which will focus on developing and implementing metrics-based care in 20 community opioid treatment programs across Pennsylvania with the goal of enhancing access to treatment, promoting recovery and reducing fatal overdoses across the Commonwealth.
Improving the quality of patient care requires full system-wide implementation support, a system-wide ability to focus on patient and provider needs, and empowering providers with clinically useful data. Successful results will set the stage for broader implementation and dissemination that has the potential to transform patient care across Pennsylvania and the nation.”
Renee Cloutier, Ph.D., principal investigator, researcher in PERU at the Pitt School of Pharmacy
Although opioid overdose deaths in Pennsylvania decreased from 2021 to 2022, opioid use disorder (OUD) and other substance use disorders remain a significant public health issue in the Commonwealth and across the country. Medications, including buprenorphine, methadone, and naltrexone, are a mainstay of treatment for OUD, but about 20% of patients discontinue treatment within the first month and up to 80% within the first six months.
According to the researchers, reducing OUD medication discontinuation rates by even a few percentage points could translate into thousands of lives saved.
“The key to reducing the impact of opioids is getting patients the right treatment at the right time, and then making sure the quality of treatment is high enough that they can move on to sustainable recovery,” Cloutier said. “Randomized clinical trials that demonstrate the impact of interventions have very controlled conditions, so often when we translate these findings into practice, we see a reduction in effectiveness because people are complex. We need better data to understand what works and what doesn’t work for patients.” .
To address this gap and improve the quality of data collected and used more systematically, PERU will expand an existing partnership with the Pennsylvania Department of Human Services Centers of Excellence on Opioid Use Disorder to integrate care that based on metrics in existing therapeutic practices and workflows.
Metrics-based care, common in physical and mental health care settings but not previously implemented in opioid treatment programs, is a model where clinicians systematically assess patients’ symptoms on a regular basis to measure how they change during their treatment and use this information to guide care on an individualized level.
“Measurement-based care is about addressing what the patient is experiencing, including symptoms from other conditions or illnesses beyond OUD,” Cloutier said. “You’re going to get information to ask what a patient needs and how clinicians can meet that need or identify barriers to why they can’t meet that need.”
The project will examine implementation effectiveness, cost-effectiveness and clinical effectiveness, including patient symptom reduction and treatment retention. These data will inform ways to increase treatment effectiveness and efficiency, while providing a roadmap for sustainable ways to scale up metrics-based care in new opioid treatment sites.
Other principal investigators on the project are Janice Pringle, Ph.D., of PERU, Kelli Scott, Ph.D., of the New England Addiction Technology Transfer Center, and Arni Aldridge, Ph.D., of the Research Triangle Institute ( RTI ) International. Co-investigators are Erh-Hsuan (Reina) Wang, Ph.D., and Debra Moore, Ph.D., both of PERU.
The HEALing Measures Center will also include collaborations between researchers at Northwestern University Feinberg School of Medicine and (RTI) International, and community partners at the Pennsylvania Department of Human Services, the Pennsylvania Department of Drug and Alcohol Programs, UPMC and Community Care Behavioral Health Organization .
Research reported in this press release is supported by the National Institute on Drug Abuse of the National Institutes of Health under award number 1RM1DA059395-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
