ArticleFederal practitioner : for the health care professionals of the VA, DoD, and PHS2021
A Facility-Wide Plan to Increase Access to Medication for Opioid Use Disorder in Primary Care and General Mental Health Settings.
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Article in Federal practitioner : for the health care professionals of the VA, DoD, and PHS, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9citing papers in PubMed
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Who cites it
9 citing papers in PubMed.
- The Behavioral Health Treatment Engagement and Retention Learning Collaborative to Improve Receipt and Continuity of Medication Treatment for Opioid Use Disorder.Substance use & addiction journal · 2026Article
- Implementation, intervention, and downstream costs for implementation of a multidisciplinary complex pain clinic in the Veterans Health Administration.Health services research · 2024Article
- Integrating Buprenorphine for Opioid Use Disorder into Rural, Primary Care Settings.Journal of general internal medicine · 2024Article
- Internal Medicine Resident Addiction Training at the Veteran's Health Administration: A Qualitative Evaluation of Site Directors' Response to the 2022 ACGME Requirements.Journal of general internal medicine · 2024Article
- Impact of Potential Case Misclassification by Administrative Diagnostic Codes on Outcome Assessment of Observational Study for People Who Inject Drugs.Open forum infectious diseases · 2024Article
- Increasing Access to Buprenorphine for Opioid Use Disorder in Primary Care: an Assessment of Provider Incentives.Journal of general internal medicine · 2023Article
- Treating opioid use disorder in veterans with co-occurring substance use: a qualitative study with buprenorphine providers in primary care, mental health, and pain settings.Addiction science & clinical practice · 2023Article
- Impact of Policy Change on Access to Medication for Opioid Use Disorder in Primary Care.Southern medical journal · 2023Article
- Understanding opportunities and challenges with telemedicine-delivered buprenorphine during the COVID-19 pandemic.Journal of substance abuse treatment · 2022Article
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Authors and funding
13 authors.
Juliette F Spelmanis a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Ellen L Edensis a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Susan Mayais a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Brent A Mooreis a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Angela Boggsis a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Robert R MacLeanis a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Princess Acklandis a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
William C Beckeris a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Donna Lynchis a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Maria Garcia-Vassallois a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Andrea L Burgois a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Marc I Rosenis a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Adam J Gordonis a Pr imary Care Physician; is an Addiction Psychiatrist and Substance Use Disorder Director, National TeleMental Health Center; is a Research Psychologist; is a Clinical Pharmacy Specialist in mental health (Clinical Resource Hub, Veterans Integrated Service Network 1); is a Clinical Psychologist; is a General Internist; is a Clinical Nurse Coordinator Outpatient Addiction; is an Addiction Psychiatrist; is a Primary Care Physician and National Co-Director for the Veterans Health Administration Primary Care Pain Initiative and Post Deployment Integrated Care Initiative; is an Addiction Psychiatrist and Director of Addiction Treatment programs; all at Veterans Affairs Connecticut Health Care System, in West Haven. is a Primary Care Physician at Beth Israel Deaconess Medical Center and an Instructor in Medicine at Harvard Medical School in Boston, Massachusetts. is an Investigator and Staff Psychologist at Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System and an Assistant Professor of Medicine at the University of Minnesota School of Medicine. is a Physician, Chief of Addiction Medicine, and Core Faculty at Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System and a Professor of Medicine and Psychiatry and Director of the Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine in Salt Lake City. Marc Rosen is a Professor of Psychiatry; Andrea Burgo is an Assistant Clinical Professor of Medicine; Maria Garcia-Vassallo is an Assistant Professor of Psychiatry; William Becker is an Associate Professor of Medicine; Robert MacLean is an Assistant Professor of Psychiatry; Ellen Edens is an Associate Professor of Psychiatry; Juliette Spelman is an Assistant Professor of Medicine; Brent Moore is a Research Scientist; all at Yale School of Medicine in New Haven.
Funding
Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9MNCATS NIH HHS UL1 TR001863
Abstract
backgroundThe opioid epidemic in the United States has generated a pressing need to enhance access to medications for opioid use disorder (MOUD). This program description illustrates a quality-improvement effort to extend MOUD to primary care and general mental health clinics within the US Department of Veterans Affairs (VA) Connecticut Healthcare system (VACHS), and to examine barriers and facilitators to implementation of MOUD in target clinics. OBSERVATIONS: As part of the national VA Stepped Care for Opioid Use Disorder Train the Trainer (SCOUTT) initiative to improve MOUD access, a VACHS team identified and resolved barriers to MOUD in target clinics. Key interventions were to obtain leadership support, increase waivered prescribers, and develop processes and tools to enhance prescribing. New initiatives included quarterly educational sessions, templated progress notes, and instant messaging for addiction specialist electronic consultations. MOUD receipt and prescriber characteristics were evaluated before and 1 year after implementation. There was a 4% increase in eligible patients receiving MOUD, from 552 (44%) to 582 (48%) (
conclusionsAn interdisciplinary team approach to identifying and overcoming barriers to MOUD target clinics expands access. Key interventions include interdisciplinary leadership engagement, proactive education and incentivization of target prescribers, removal of procedural barriers, and development of tools to facilitate and support prescribing. These concrete interventions can help inform other institutions interested in expanding MOUD access.
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