HEALing Measurement Center: Enhancing Opioid Use Disorder Recovery through Measurement Based Care

OUD remains a critical public health crisis in Pennsylvania. The state-funded Pennsylvania Centers of Excellence have been charged with providing OUD treatment, including medication for OUD (MOUD), to facilitate recovery and reduce the impact of fatal overdose throughout the state. Despite efforts to improve access to effective treatments for OUD such as medications and integrated behavioral health services, national OUD overdose and overdose death rates remain alarmingly high. Current MOUD interventions primarily targeting reduction in OUD symptoms have significant dropout rates (20-50%) and result in remission of OUD for ~36 percent of individuals. The patients with co-occurring substance use and psychological disorders are at greater risk for poor outcomes, often because they have more complex treatment needs that are hard to identify, track, and respond to in real time. To improve OUD intervention outcomes, the overarching goal of the HEALing Measures Center at University of Pittsburgh is to enhance the measurement and quality of care delivered in OUD treatment programs (OTPs) through sustained implementation of measurement-based care (MBC). Specifically, the three proposed projects were designed to address the immediate concerns expressed by our partners while simultaneously meeting critical research gaps. Research Plan 1 will develop an MBC Implementation Blueprint including technical assistance, learning networks, and paperwork reduction strategies. Research Plan 2 will demonstrate the fidelity, efficiency and effectiveness of implementing enhanced MBC implementation (MBC+) versus measurement as usual (MAU) via a stepped-wedge, hybrid type II effectiveness-implementation trial. Research Plan 3 will demonstrate the clinical effectiveness of MBC+ relative to MAU for patients with co-occurring OUD and psychological diagnoses. The proposed study will provide critical preliminary evidence regarding the role and significance of capitalizing on MBC in OUD interventions, enhanced implementation of a sustainable, cost-reducing and effective MBC intervention via implementation strategies that are co-designed with partners (state, payer, and OTP), and alternative avenues to potentially enhance symptom-related outcomes and treatment retention of OUD interventions with downstream public health benefits.