Evidence map›Paper›PMID 37091088›Full record

ArticleImplementation research and practice

Together in care: Lessons learned at the intersection of integrated care, quality improvement, and implementation practice in opioid treatment programs.

Megan A O'Grady, Rina Randrianarivony, Keith Martin, Yaberci Perez-Cubillan, David C Collymore, Dina Shapiro-Luft, Alexa Beacham, Nyasia Heyward, Belinda Greenfield, Charles J Neighbors

Abstract read
In one paragraph

Article in Implementation research and practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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

10 authors.

Megan A O'GradyDepartmet of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA.ORCID https://orcid.org/0000-0002-1121-734X
Rina RandrianarivonyPartnership to End Addiction, New York, NY, USA.
Keith MartinAcacia Network, Bronx, NY, USA.
Yaberci Perez-CubillanAcacia Network, Bronx, NY, USA.
David C CollymoreAcacia Network, Bronx, NY, USA.
Dina Shapiro-LuftPartnership to End Addiction, New York, NY, USA.
Alexa BeachamPartnership to End Addiction, New York, NY, USA.
Nyasia HeywardBureau of Adult Treatment, New York State Office of Addiction Services and Supports, New York, USA.
Belinda GreenfieldBureau of Adult Treatment, New York State Office of Addiction Services and Supports, New York, USA.
Charles J NeighborsDepartment of Population Health, New York University Grossman School of Medicine, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Integrated care programs that systematically and comprehensively address both behavioral and physical health may improve patient outcomes. However, there are few examples of such programs in addiction treatment settings. This article is a practical implementation report describing the implementation of an integrated care program into two opioid treatment programs (OTPs). Method: Strategies used to implement integrated care into two OTPs included external facilitation, quality improvement (QI) processes, staff training, and an integrated organizational structure. Service, implementation, and client outcomes were examined using qualitative interviews with program staff (n  =  16), program enrollment data, and client outcome data (n  =  593) on mental health (MH), physical health, and functional indicators. Results: Staff found the program to generally be acceptable and appropriate, but also noted that the new services added to already busy workflows and more staffing were needed to fully reach the program's potential. The program had a high level of penetration (∼60%-70%), enrolling over 1,200 clients. Staff noted difficulties in connecting clients with some services. Client general functioning and MH symptoms improved, and heavy smoking decreased. The organizational structure and QI activities provided a strong foundation for interactive problem-solving and adaptations that were needed during implementation. Conclusions: This article highlights an example of the intersection of QI and implementation practice. Simplified QI processes, consistent post-implementation meetings, and change teams and champions facilitated implementation; however, ongoing training and support, especially related to data are needed. The OTP setting provided a strong foundation to build integrated care, but careful consideration of new workflows and changes in philosophy for staff is necessary.

Indexed as

implementation practiceintegrated caremental healthmethadone maintenanceopioid treatment programprimary carequality improvement

Identifiers

PMID37091088
PMCPMC9924288

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.