Evidence map›Paper›PMID 33675619›Full record

ArticleJournal of acquired immune deficiency syndromes (1999)2021

Readiness to Provide Medications for Addiction Treatment in HIV Clinics: A Multisite Mixed-Methods Formative Evaluation.

E Jennifer Edelman, Geliang Gan, James Dziura, Denise Esserman, Kenneth L Morford, Elizabeth Porter, Philip A Chan, Deborah H Cornman, Benjamin J Oldfield, Jessica E Yager and 2 more

Registry-linked trialOpen access · greenAbstract readMulticenter Study
In one paragraph

Article in Journal of acquired immune deficiency syndromes (1999), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02907944 (Working With HIV Clinics to Adopt Addiction Treatments Using Implementation Facilitation), which is not on this map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
1.3field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02907944 nacompletednot on this map

Working With HIV Clinics to Adopt Addiction Treatments Using Implementation Facilitation (WHAT-IF?)

TypeinterventionalSponsorYale UniversityRan2016 to 2021Enrolled3,838ConditionsSubstance-related DisordersArmsImplementation Facilitation
3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 24 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

E Jennifer EdelmanProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT.
Geliang GanYale Center for Analytic Sciences, Yale School of Public Health, New Haven, CT.
James DziuraYale Center for Analytic Sciences, Yale School of Public Health, New Haven, CT.
Denise EssermanYale Center for Analytic Sciences, Yale School of Public Health, New Haven, CT.
Kenneth L MorfordProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT.
Elizabeth PorterDepartment of Internal Medicine, Yale School of Medicine, New Haven, CT.
Philip A ChanDepartment of Medicine, Brown University, Providence, RI.
Deborah H CornmanInstitute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT.
Benjamin J OldfieldProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT.
Jessica E YagerDepartment of Medicine, SUNY Downstate, Brooklyn, NY; and.
Srinivas B MuvvalaProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT.
David A FiellinProgram in Addiction Medicine, Yale School of Medicine, New Haven, CT.
Yale University · USBrown University · USSUNY Downstate Health Sciences University · USUniversity of Connecticut · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
The Brown Initiative in HIV and AIDS Clinical Research for Minority CommunitiesR25MH083620 · NIMH · MIRIAM HOSPITAL · PI NUNN, AMY STEWART · 2008 to 2025
$3.7M
Working with HIV clinics to adopt addiction treatments using Implementation Facilitation (WHAT IF?)R01DA041067 · NIDA · YALE UNIVERSITY · PI FIELLIN, DAVID · 2015 to 2019
$2.9M
NCATS NIH HHS UL1 TR001863NIDA NIH HHS R01 DA041067NIMH NIH HHS R25 MH083620
6 · The paper itself

Abstract

backgroundWe sought to characterize readiness, barriers to, and facilitators of providing medications for addiction treatment (MAT) in HIV clinics.

settingFour HIV clinics in the northeastern United States.

methodsMixed-methods formative evaluation conducted June 2017-February 2019. Surveys assessed readiness [visual analog scale, less ready (0-<7) vs. more ready (≥7-10)]; evidence and context ratings for MAT provision; and preferred addiction treatment model. A subset (n = 37) participated in focus groups.

resultsAmong 71 survey respondents (48% prescribers), the proportion more ready to provide addiction treatment medications varied across substances [tobacco (76%), opioid (61%), and alcohol (49%) treatment medications (P values < 0.05)]. Evidence subscale scores were higher for those more ready to provide tobacco [median (interquartile range) = 4.0 (4.0, 5.0) vs. 4.0 (3.0, 4.0), P = 0.008] treatment medications, but not significantly different for opioid [5.0 (4.0, 5.0) vs. 4.0 (4.0, 5.0), P = 0.11] and alcohol [4.0 (3.0, 5.0) vs. 4.0 (3.0, 4.0), P = 0.42] treatment medications. Median context subscale scores ranged from 3.3 to 4.0 and generally did not vary by readiness status (P values > 0.05). Most favored integrating MAT into HIV care but preferred models differed across substances. Barriers to MAT included identification of treatment-eligible patients, variable experiences with MAT and perceived medication complexity, perceived need for robust behavioral services, and inconsistent availability of on-site specialists. Facilitators included knowledge of adverse health consequences of opioid and tobacco use, local champions, focus on quality improvement, and multidisciplinary teamwork.

conclusionsEfforts to implement MAT in HIV clinics should address both gaps in perspectives regarding the evidence for MAT and contextual factors and may require substance-specific models.

Indexed as

HIV-1AlcoholismHealth Services AccessibilityHIV InfectionsHumansOpioid-Related DisordersSubstance-Related DisordersTobacco Use Cessation

Identifiers

PMID33675619
PMCPMC8192340
OpenAlexW3134014596

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.