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Addiction Science & Clinical Practice
Published in: Addiction Science & Clinical Practice 1/2019

Open Access 01-12-2019 | Buprenorphine | Research

Building a Group-Based Opioid Treatment (GBOT) blueprint: a qualitative study delineating GBOT implementation

Authors: Randi Sokol, Mark Albanese, Aaronson Chew, Jessica Early, Ellie Grossman, David Roll, Greg Sawin, Dominic J. Wu, Zev Schuman-Olivier

Published in: Addiction Science & Clinical Practice | Issue 1/2019

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Abstract

Background

Group-Based Opioid Treatment (GBOT) has recently emerged as a mechanism for treating patients with opioid use disorder (OUD) in the outpatient setting. However, the more practical “how to” components of successfully delivering GBOT has received little attention in the medical literature, potentially limiting its widespread implementation and utilization. Building on a previous case series, this paper delineates the key components to implementing GBOT by asking: (a) What are the core components to GBOT implementation, and how are they defined? (b) What are the malleable components to GBOT implementation, and what conceptual framework should providers use in determining how to apply these components for effective delivery in their unique clinical environment?

Methods

To create a blueprint delineating GBOT implementation, we integrated findings from a previously conducted and separately published systematic review of existing GBOT studies, conducted additional literature review, reviewed best practice recommendations and policies related to GBOT and organizational frameworks for implementing health systems change. We triangulated this data with a qualitative thematic analysis from 5 individual interviews and 2 focus groups representing leaders from 5 different GBOT programs across our institution to identify the key components to GBOT implementation, distinguish “core” and “malleable” components, and provide a conceptual framework for considering various options for implementing the malleable components.

Results

We identified 6 core components to GBOT implementation that optimize clinical outcomes, comply with mandatory policies and regulations, ensure patient and staff safety, and promote sustainability in delivery. These included consistent group expectations, team-based approach to care, safe and confidential space, billing compliance, regular monitoring, and regular patient participation. We identified 14 malleable components and developed a novel conceptual framework that providers can apply when deciding how to employ each malleable component that considers empirical, theoretical and practical dimensions.

Conclusion

While further research on the effectiveness of GBOT and its individual implementation components is needed, the blueprint outlined here provides an initial framework to help office-based opioid treatment sites implement a successful GBOT approach and hence potentially serve as future study sites to establish efficacy of the model. This blueprint can also be used to continuously monitor how components of GBOT influence treatment outcomes, providing an empirical framework for the ongoing process of refining implementation strategies.
Appendix
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Footnotes
1
An impulsive action that happens once with regret.
 
2
A return to the addiction behavior that is time-limited with less immediate insight.
 
3
A return to original level of use or problematic behaviors.
 
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Metadata
Title
Building a Group-Based Opioid Treatment (GBOT) blueprint: a qualitative study delineating GBOT implementation
Authors
Randi Sokol
Mark Albanese
Aaronson Chew
Jessica Early
Ellie Grossman
David Roll
Greg Sawin
Dominic J. Wu
Zev Schuman-Olivier
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Addiction Science & Clinical Practice / Issue 1/2019
Electronic ISSN: 1940-0640
DOI
https://doi.org/10.1186/s13722-019-0176-y

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