0BPROJECT SUMMARY/ABSTRACT
Opioid overdose deaths reached the highest level ever in 2021. Medications to treat opioid use disorder
(MOUD) can markedly reduce overdose risks when taken for long enough. More than 650,000 people
receive MOUD in Opioid Treatment Programs (OTPs) annually. Unfortunately, on average, less than half of
patients stay in opioid use disorder (OUD) treatment for the recommended minimum 1 year of time. OTP
retention and outcome quality measures (i.e., “audit and feedback”) may improve treatment retention rates
and outcomes. Quality measures can also help monitor the effect of new OTP reimbursement and regulatory
policies. Eventually, OTP quality measures could be incorporated into the Federal government’s public
facing healthcare provider Compare website. However, research is needed to determine how to most
effectively create and disseminate OTP quality measures. The literature on audit and feedback points to
three features that influence the probability that measures will result in improved quality: (1) the
characteristics of the measures and benchmarks, (2) the knowledge that providers have about how to
improve the measures, and (3) the control that providers have over the factors that matter to improve the
measure. This study will test approaches for optimizing each of these factors.
NIDA RFA-DA-23-046 is supporting multi-project OUD Quality Measurement and Management Research
Centers that pair researchers with partner organizations that have an OUD quality measurement and
management strategy that research could advance. RTI International, University of California Los Angeles,
and Beacon Health Connecticut are the research organizations leading this study. They are partnering with
two organizations that need to develop an effective OTP quality measurement and management system:
BayMark Health Services and the Los Angeles County Division of Substance Abuse Prevention and Control.
The team is implementing three inter-related research projects with the following overall aims:
Overall Aim 1. Create and psychometrically test OTP measures of retention, overdose emergency
department visits, overdose hospitalizations, and mortality with benchmarks and toolkits describing how
OTPs can improve retention.
Overall Aim 2. Test the effect of the giving OTPs quality measures and information on how to improve
retention (a retention toolkit), with and without quality improvement training, by conducting a clustered
randomized trial that assigns OTPs to receive either: (1) retention and outcome measures with the toolkit; or
(2) retention and outcome meaures with the toolkit as well as quality improvement (QI) training (i.e., NIATx)
(Arm 2), or (3) treatment as usual (Control Arm).
Overall Aim 3. Test the effect of aligning OTP-level and LA county population-level OUD measures on
retention and outcomes in LA county relative to other counties in California.