Evidence map›Paper›PMID 39313353›Full record

ArticleAnnals of family medicine

The Odyssey of HOMER: Comparative Effectiveness Research on Medication for Opioid Use Disorder During the COVID-19 Pandemic.

Linda Zittleman, John M Westfall, Benjamin Sofie, Cory Lutgen, Douglas Fernald, Tristen L Hall, Camille J Hochheimer, Melanie Murphy, Maret Felzien, L Miriam Dickinson and 3 more

Abstract read
In one paragraph

Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Induction of Medication for Opioid Use Disorder in Primary Care.Journal of the American Board of Family Medicine : JABFM · 2025
    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

13 authors.

Linda ZittlemanUniversity of Colorado Department of Family Medicine, Aurora, Colorado Linda.Zittleman@cuanschutz.edu.
John M WestfallUniversity of Colorado Department of Family Medicine, Aurora, Colorado.
Benjamin SofieUniversity of Colorado Department of Family Medicine, Aurora, Colorado.
Cory LutgenAAFP National Research Network at the DARTNet Institute, Aurora, Colorado.
Douglas FernaldUniversity of Colorado Department of Family Medicine, Aurora, Colorado.
Tristen L HallUniversity of Colorado Department of Family Medicine, Aurora, Colorado.
Camille J HochheimerUniversity of Colorado Department of Family Medicine, Aurora, Colorado.
Melanie MurphyHOMER Community Advisory Council.
Maret FelzienHOMER Community Advisory Council.
L Miriam DickinsonUniversity of Colorado Department of Family Medicine, Aurora, Colorado.
Brian K ManningAAFP National Research Network at the DARTNet Institute, Aurora, Colorado.
Joseph LeMasterAAFP National Research Network at the DARTNet Institute, Aurora, Colorado.
Donald E NeaseUniversity of Colorado Department of Family Medicine, Aurora, Colorado.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The usual challenges of conducting primary care research, including randomized trials, have been exacerbated, and new ones identified, during the COVID-19 pandemic. HOMER (Home versus Office for Medication Enhanced Recovery; subsequently, Comparing Home, Office, and Telehealth Induction for Medication Enhanced Recovery) is a pragmatic, comparative-effectiveness research trial that aims to answer a key question from patients and clinicians: What is the best setting in which to start treatment with buprenorphine for opioid use disorder for this patient at this time? In this article, we describe the difficult journey to find the answer. The HOMER study began as a randomized trial comparing treatment outcomes in patients starting treatment with buprenorphine via induction at home (unobserved) vs in the office (observed, synchronous). The study aimed to enroll 1,000 participants from 100 diverse primary care practices associated with the State Networks of Colorado Ambulatory Practices and Partners and the American Academy of Family Physicians National Research Network. The research team faced unexpected challenges related to the COVID-19 pandemic and dramatic changes in the opioid epidemic. These challenges required changes to the study design, protocol, recruitment intensity, and funding conversations, as well as patience. As this is a participatory research study, we sought, documented, and responded to practice and patient requests for adaptations. Changes included adding a third study arm using telehealth induction (observed via telephone or video, synchronous) and switching to a comprehensive cohort design to answer meaningful patient-centered research questions. Using a narrative approach based on the Greek myth of Homer, we describe here the challenges and adaptations that have provided the opportunity for HOMER to thrive and find the way home. These clinical trial strategies may apply to other studies faced with similar cultural and extreme circumstances.

Indexed as

BuprenorphineComparative Effectiveness ResearchCOVID-19Opiate Substitution TreatmentOpioid-Related DisordersColoradoHumansNarcotic AntagonistsPandemicsPragmatic Clinical Trials as TopicPrimary Health CareSARS-CoV-2TelemedicineBuprenorphineNarcotic Antagonistsbuprenorphineclinical trials as topicCOVID-19health servicesopioid use disorderpandemicsparticipatory researchpractice-based researchprimary carevulnerable populations

Identifiers

PMID39313353
PMCPMC11419717

What OpenQuestion holds

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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.