Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Implementation Science
Published in: Implementation Science 1/2013

Open Access 01-12-2013 | Study protocol

Testing use of payers to facilitate evidence-based practice adoption: protocol for a cluster-randomized trial

Authors: Todd Molfenter, Jee-Seon Kim, Andrew Quanbeck, Terry Patel-Porter, Sandy Starr, Dennis McCarty

Published in: Implementation Science | Issue 1/2013

Login to get access

Abstract

Background

More effective methods are needed to implement evidence-based findings into practice. The Advancing Recovery Framework offers a multi-level approach to evidence-based practice implementation by aligning purchasing and regulatory policies at the payer level with organizational change strategies at the organizational level.

Methods

The Advancing Recovery Buprenorphine Implementation Study is a cluster-randomized controlled trial designed to increase use of the evidence-based practice buprenorphine medication to treat opiate addiction. Ohio Alcohol, Drug Addiction, and Mental Health Services Boards (ADAMHS), who are payers, and their addiction treatment organizations were recruited for a trial to assess the effects of payer and treatment organization changes (using the Advancing Recovery Framework) versus treatment organization changes alone on the use of buprenorphine. A matched-pair randomization, based on county characteristics, was applied, resulting in seven county ADAMHS boards and twenty-five treatment organizations in each arm. Opioid dependent patients are nested within cluster (treatment organization), and treatment organization clusters are nested within ADAMHS county board. The primary outcome is the percentage of individuals with an opioid dependence diagnosis who use buprenorphine during the 24-month intervention period and the 12-month sustainability period. The trial is currently in the baseline data collection stage.

Discussion

Although addiction treatment providers are under increasing pressure to implement evidence-based practices that have been proven to improve patient outcomes, adoption of these practices lags, compared to other areas of healthcare. Reasons frequently cited for the slow adoption of EBPs in addiction treatment include, regulatory issues, staff, or client resistance and lack of resources. Yet the way addiction treatment is funded, the payer’s role—has not received a lot of attention in research on EBP adoption.
This research is unique because it investigates the role of payers in evidence-based practice implementation using a randomized controlled design instead of case examples. The testing of the Advancing Recovery Framework is designed to broaden the understanding of the impact payers have on evidence-based practice (EBP) adoption.

Trial registration

http://​NCT01702142 (ClinicalTrials.gov registry, USA)
Appendix
Available only for authorised users
Literature
1.
Baker TB, McFall RM, Shoham V: Current status and future prospects of clinical psychology: toward a scientifically principled approach to mental and behavioral health care. Psychol Sci Public Interest. 2008, 9 (2): 67-103.PubMed
2.
Bodenheimer T: The American health care system–the movement for improved quality in health care. N Engl J Med. 1999, 340 (6): 488-492. 10.1056/NEJM199902113400621.CrossRefPubMed
3.
Institute of Medicine: Bridging the gap between practice and research: forging partnerships with community based drug and alcohol treatment. 1998, Washington, DC: National Academy Press
4.
Willinbring ML, Kivlahan D, Kenny M, Grillo M, Hagedorn H, Postier A: Beliefs about evidence-based practices in addiction treatment: a survey of veterans administration program leaders. J Subst Abuse Treat. 2004, 26 (2): 79-85. 10.1016/S0740-5472(03)00161-2.CrossRef
5.
Garner B: Research on the diffusion of evidence-based treatments within substance abuse treatment: a systematic review. J Subst Abuse Treat. 2009, 36 (4): 376-399. 10.1016/j.jsat.2008.08.004.CrossRefPubMed
6.
Moore TJ, Cohen MR, Furberg CD: Serious adverse drug events reported to the food and drug administration, 1998–2005. Arch Intern Med. 2007, 167 (16): 1752-10.1001/archinte.167.16.1752.CrossRefPubMed
7.
O’Brien CP: Recent developments in the pharmacotherapy of substance abuse. J Consult Clin Psychol. 1996, 64 (4): 677-686.CrossRefPubMed
8.
Harris AH, Gospodarevskaya E, Ritter AJ: A randomised trial of the cost effectiveness of buprenorphine as an alternative to methadone maintenance treatment for heroin dependence in a primary care setting. PharmacoEconomics. 2005, 23 (1): 77-91. 10.2165/00019053-200523010-00007.CrossRefPubMed
9.
Knudsen HK, Abraham AJ, Roman PM: Adoption and implementation of medications in addiction treatment programs. J Addict Med. 2011, 5: 21-27. 10.1097/ADM.0b013e3181d41ddb.CrossRefPubMedPubMedCentral
10.
Knudsen HK, Roman PM: Financial factors and the implementation of medications for treating opioid use disorders. J Addict Med. 2012, 6 (4): 280-286. 10.1097/ADM.0b013e318262a97a.CrossRefPubMedPubMedCentral
11.
Wallack S, Thomas C, Martin T, Chilingerian J, Reif S: Substance abuse treatment organizations as mediators of social policy: slowing the adoption of a congressionally approved medication. J Behav Health Serv Res. 2010, 37 (1): 64-78. 10.1007/s11414-008-9132-4.CrossRefPubMed
12.
Stein BD, Gordon AJ, Sorbero M, Dick AW, Schuster J, Farmer C: The impact of buprenorphine on treatment of opioid dependence in a Medicaid population: recent service utilization trends in the use of buprenorphine and methadone. Drug Alcohol Depend. 2012, 123 (1–3): 72-78.CrossRefPubMed
13.
Ferlie EW, Shortell SH: Improving the quality of health care in the United Kingdom and the United States: a framework for change. Milbank Q. 2001, 79 (2): 281-315. 10.1111/1468-0009.00206.CrossRefPubMedPubMedCentral
14.
Grol R: Improving the quality of medical care: building bridges among professional pride, payer profit, and patient satisfaction. JAMA. 2001, 286 (20): 2578-2585. 10.1001/jama.286.20.2578.CrossRefPubMed
15.
Slavin RE: Research on achievement outcomes of success for all. Phi Delta Kappan. 2000, 82 (1): 38.CrossRef
16.
Rogers EM: Diffusion of innovations. 2003, New York: Free Press
17.
Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004, 82 (4): 581-629. 10.1111/j.0887-378X.2004.00325.x.CrossRefPubMedPubMedCentral
18.
Schmidt LA, Rieckmann T, Abraham A, Molfenter T, Capoccia V, Roman P, Gustafson DH, McCarty D: Advancing Recovery: implementing evidence-based treatment for substance use disorders at the systems level. J Stud Alcohol Drugs. 2012, 73 (3): 413-422.CrossRefPubMedPubMedCentral
19.
Simpson DD: A conceptual framework for transferring research to practice. J Subst Abuse Treat. 2002, 22 (4): 171-182. 10.1016/S0740-5472(02)00231-3.CrossRefPubMed
20.
Proctor EK: Leverage points for the implementation of evidence-based practice. Brief Treat Crisis Interv. 2004, 4 (3): 227-242. 10.1093/brief-treatment/mhh020.CrossRef
21.
Mark TL, Levit KR, Coffey RM, McKusick DR, Harwood HJ, King EC, Bouchery E, Genuardi JS, Vandivort-Warren R, Buck JA, Ryan K: National expenditures for mental health services and substance abuse treatment: 1993-2003.Vol SAMHSA Publication No. SMA 07-4227. 2007, Rockville, MD: Substance Abuse and Mental Health ServicesAdministration
22.
Quanbeck AR, Gustafson DH, Ford JH, Pulvermacher A, French MT, McConnell KJ, McCarty D: Disseminating quality improvement: study protocol for a large cluster randomized trial. Implement Sci. 2011, 6 (1): 44-10.1186/1748-5908-6-44.CrossRefPubMedPubMedCentral
23.
Gustafson DH, Quanbeck AR, Robinson JM, Ford JH, Pulvermacher A, French MT, McConnell KJ, Batalden PB, Hoffman KA, McCarty D: Which elements of improvement collaboratives are most effective? a cluster-randomized trial. Addiction. in press
24.
Hsieh FY, Lavori PW, Cohen HJ, Feussner JR: An overview of variance inflation factors for sample-size calculation. Eval Health Prof. 2003, 26 (3): 239-257. 10.1177/0163278703255230.CrossRefPubMed
25.
26.
Knudsen HK, Ducharme LJ, Roman PM: Early adoption of buprenorphine in substance abuse treatment centers: data from the private and public sectors. J Subst Abuse Treat. 2006, 30 (4): 363-373. 10.1016/j.jsat.2006.03.013.CrossRefPubMed
27.
28.
Raudenbush SW, Liu X: Statistical power and optimal design for multisite randomized trials. Psychol Methods. 2000, 5 (2): 199-213.CrossRefPubMed
29.
Aarons GA, Hurlburt M, Horwitz SM: Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011, 38 (1): 4-23. 10.1007/s10488-010-0327-7.CrossRefPubMed
30.
McGovern MP, Saunders EC, Kim E: Substance abuse treatment implementation research. J Subst Abuse Treat. 2013, 44 (1): 1-3. 10.1016/j.jsat.2012.09.006.CrossRefPubMed
31.
Gilbert CM, O’Donnell E: The hospital library’s role in recruitment and retention of medical staff. J Hosp Librariansh. 2004, 4 (4): 7-30. 10.1300/J186v04n04_02.CrossRef
32.
Chamberlain P, Brown CH, Saldana L, Reid J, Wang W, Marsenich L, Sosna T, Padgett C, Bouwman G: Engaging and recruiting counties in an experiment on implementing evidence-based practice in California. Adm Policy Ment Health. 2008, 35 (4): 250-260. 10.1007/s10488-008-0167-x.CrossRefPubMedPubMedCentral
33.
Magnabosco JL: Innovations in mental health services implementation: a report on state-level data from the National Evidence-Based Practices Project. Implement Sci. 2006, 1: 13-10.1186/1748-5908-1-13.CrossRefPubMedPubMedCentral
34.
Bruns EJ, Hoagwood KE, Rivard JC, Wotring J, Marsenich L, Carter B: State implementation of evidence-based practice for youths, Part II: recommendations for research and policy. J Am Acad Child Adolesc Psychiatry. 2008, 47: 499-504. 10.1097/CHI.0b013e3181684557.CrossRefPubMed
35.
Shea MA, Callis BP, Cassidy-Stewart H, Cranston K, Tomoyasu N: Diffusion of effective HIV prevention interventions--lessons from Maryland and Massachusetts. AIDS Educ Prev. 2006, 18: 96-107. 10.1521/aeap.2006.18.supp.96.CrossRefPubMed
36.
Raghavan R, Bright CL, Shadoin A: Toward a policy ecology of implementation of evidence-based practices in public mental health settings. Implement Sci. 2008, 3 (1): 26-10.1186/1748-5908-3-26.CrossRefPubMedPubMedCentral
37.
Ganju V: Implementation of evidence-based practices in state mental health systems. Schizophr Bull. 2003, 29: 125-131. 10.1093/oxfordjournals.schbul.a006982.CrossRefPubMed
38.
Rapp CA, Bond GR, Becker DR, Carpinello SE, Nikkel RE, Gintoli G: The role of state mental health authorities in promoting improved client outcomes through evidence-based practice. Community Ment Health J. 2005, 41: 347-363. 10.1007/s10597-005-5008-8.CrossRefPubMed
39.
Isett KR, Burnam MA, Coleman-Beattie B, Hyde PS, Morrissey JP, Magnabosco JL, Rapp C, Ganju V, Goldman HH: The role of state mental health authorities in managing change for the implementation of evidence-based practices. Community Ment Health J. 2008, 44: 195-211. 10.1007/s10597-007-9107-6.CrossRefPubMed
Metadata
Title
Testing use of payers to facilitate evidence-based practice adoption: protocol for a cluster-randomized trial
Authors
Todd Molfenter
Jee-Seon Kim
Andrew Quanbeck
Terry Patel-Porter
Sandy Starr
Dennis McCarty
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2013
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/1748-5908-8-50

Other articles of this Issue 1/2013

Implementation Science 1/2013 Go to the issue

Research

The role of evidence, context, and facilitation in an implementation trial: implications for the development of the PARIHS framework

Research

Public health program capacity for sustainability: a new framework

Research

A realist review of interventions and strategies to promote evidence-informed healthcare: a focus on change agency

Research

Development and psychometric properties of a questionnaire to assess barriers to feeding critically ill patients

Research

An intervention to improve program implementation: findings from a two-year cluster randomized trial of Assets-Getting To Outcomes

Study protocol

Improving evidence-based primary care for chronic kidney disease: study protocol for a cluster randomized control trial for translating evidence into practice (TRANSLATE CKD)