New NIATx project: Implementing buprenorphine in Ohio

Opioid addiction has become a major health concern in Ohio, where deaths due to accidental opioid overdoses have increased by 304 percent over the past decade and surpassed auto accidents as the leading cause of death in 2006. NIATx, a process improvement center based at the University of Wisconsin-Madison, has received a five-year grant from the National Institute on Drug Abuse study the impact of payer and provider strategies in implementing buprenorphine (Suboxone®) in Ohio. This medication has proven effective in helping people overcome opioid addiction, but has low adoption rates in Ohio.

The study, a randomized controlled trial, will test ways to implement buprenorphine through payer-treatment agency partnerships more than 20 Ohio counties. Participating county boards and agencies will be randomized into two study conditions. Under one condition, participants will work on implementing the medication using only the NIATx process improvement model. In this model, a team selects an aim, collects data, and tests a series of small, rapid changes in quick succession, finally adopting a change when data shows it to be effective. In the second condition, participants will use the NIATx model and additional change strategies at the payer level.

Todd Molfenter, deputy director of NIATx and principal investigator for the study says, "We've learned in earlier studies that payers can influence the adoption of new practices by making changes in financing and regulatory systems. The aim of the study is to determine which systems changes have the greatest impact on implementation of buprenorphine."

Partners in the study include the Ohio Department of Alcohol and Drug Addiction Services (ODADAS) and the Ohio Association of County Behavioral Health Authorities.

The study is now recruiting Ohio participants. Regional information sessions on buprenorphine will begin in Fall 2012, with training on the NIATx model of process improvement to follow in February 2013. The study will also provide a burprenorphine training program for participating physicians.

Says Molfenter, "We're excited about this opportunity to help Ohio communities address the problem of opioid addiction."