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Announcing CTN-0103, “Expanding Clinical Research Training on Implementing the Evidence-based Hub and Spoke Model of Medication-Assisted Treatment for Opioid Use Disorder”

The Northeast Node is pleased to announce CTN-0103, entitled “Expanding Clinical Research Training on Implementing the Evidence-based Hub and Spoke Model of Medication-Assisted Treatment for Opioid Use Disorder”. The Vermont Hub and Spoke Model (VT HSM) of substance use disorder care allows providers to initiate medication treatment for persons with opioid use disorder with assistance from local opioid treatment programs (Hubs) and then support ongoing care of patients through office-based treatment (Spokes) (with flexible movement back into Hubs for patients in need of additional stabilization). The Node will collaborate with its partner, the New Hampshire (NH) Citizens Health Initiative, that helps lead the Northern New England (NNE) Project ECHO (Extension for Community Healthcare Outcomes) Network across ME, NH, and VT. The NNE ECHO is an expansive collaborative designed to implement a regional network of telehealth services for sharing of knowledge from multidisciplinary expert mentors and teams across a virtual network using the Project ECHO model. This model uses web-supported case-based learning to provide direct education and support to clinicians and communities addressing the opioid epidemic to improve access, care delivery, outcomes and health.

As part of this ongoing teleECHO learning collaborative (LC), CTN-0103 will expand clinical research training in evidence-based quality improvement (QI) methods that were central to delivering and sustaining science-based medication-assisted treatment for opioid use disorder (MOUD) within the VT HSM with fidelity. To do so, participating primary care practices will be trained in the use of a study-developed toolkit of research and evaluation methods that have been shown to be critical to the impact of the HSM, and the Northeast Node will systematically evaluate the impact of this training. The toolkit will initially be offered to NH providers in the NNE Project ECHO, with the potential to expand to other states. In addition to the learning provided by the ECHO modules, the study will train participating practices to systematically track standardized outcome metrics and regularly share their practice’s data with other LC members. Practices can then use this information to refine their care model over time, with goals of improving fidelity to best practices for MOUD, promoting optimal patient outcomes, targeting areas for improvement, and giving practices additional tools to sustain the learning provided in the ECHO. Over the course of the ECHO LC, the study will measure changes in providers’ knowledge about best practices for MOUD, their comfort in caring for OUD patients with MOUD, and their performance on relevant standardized outcome metrics.

Overall, this initiative will support training in clinical research and evaluation methods to best implement and sustain the evidence-based HSM of MOUD.  TeleECHO offers considerable promise for supporting a broad learning collaborative/training mechanism within the HSM among geographically-dispersed providers, such as those in rural NH.