Choctaw Nation MOUD Clinic Expansion and Enhancement Through Physician Training and Multidisciplinary Care - Choctaw Nation of Oklahoma seeks to improve and preserve the lives of Choctaw people through expanded access to care and enhanced quality of multidisciplinary MOUD services offered within the Choctaw Nation Family Medicine Residency (CNFMR) Clinic. By training resident physicians to confidently and competently provide MOUD services, we aim to address the workforce shortage experienced across Oklahoma and the Choctaw Nation. The goals of the project include:
1. Increasing access to MOUD for individuals with Opioid Use Disorder among the tribal population of the Choctaw Nation of Oklahoma using a multidisciplinary approach to SUD/OUD treatment.
2. Decreasing illicit opioid use and prescription opioid misuse among the tribal population of the Choctaw Nation of Oklahoma through a multidisciplinary MOUD program.
3. Improving the workforce shortage of MOUD treatment providers by training resident physicians in multidisciplinary MOUD care.
Goals will be accomplished through objectives including the establishment of a multidisciplinary MOUD treatment team including resident and attending physicians, a decentralized pharmacist, a registered nurse case manager, and a licensed professional counselor. The team will establish care plans for the enhancement of existing MOUD services to treat at least 6 new, unduplicated patients with opioid use disorder (OUD) per year, while simultaneously training at least 15 resident physicians to provide MOUD services independently by completion of the project period. With a proven history of success, CNFMR intends to retain at least 25% of residency graduates for service across Choctaw Nation and 75% for service in rural or medically underserved populations/areas. These physicians will be fully trained to provide MOUD services when practicing independently, including within Choctaw Nation Health Services Authority satellite clinics.
The American Academy of Family Physicians affirms that primary care physicians are uniquely positioned to address the needs of patients with OUD through the delivery of patient-centered and compassionate care to the diverse populations they serve. An Office-Based Opioid Treatment (OBOT) approach will be used to overcome barriers to MOUD treatment in the rural, tribal target population. OBOT within an existing primary care clinic providing culturally-competent care presents an opportunity for MOUD treatment in a setting with established trust in patient-physician and patient-staff relationships. This care will be further enhanced by interprofessional teaming to fully support recovery and sustained remission of OUD. Knowledge gained from the project will promote overall quality improvement of SUD/OUD treatment, access to MOUD services, and overall health and quality of life of Native American families and communities.
