Replication of an emergency department-based recovery coaching intervention and pilot testing of pragmatic trial protocols within the context of Indiana's Opioid State Targeted Response plan

Dennis P. Watson, Krista Brucker, Alan McGuire, Nyssa L. Snow-Hill, Huiping Xu, Alex Cohen, Mark Campbell, Lisa Robison, Emily Sightes, Rebecca Buhner, Daniel O'Donnell, Jeffrey Kline

Research output: Contribution to journalArticle

Abstract

Solving the opioid crisis requires immediate, innovative, and sustainable solutions. A number of promising strategies are being carried out by U.S. states and territories as part of their Opioid State Targeted Response (STR) plans funded through the 21st Century Cures Act, and they provide an opportunity for researchers to assess effectiveness of these interventions using pragmatic approaches. This paper describes a pilot study of Project Planned Outreach, Intervention, Naloxone, and Treatment (POINT), the intervention that served as the basis for Indiana's STR-funded, emergency department (ED)-based peer specialist expansion that was conducted in preparation for a larger, multisite pragmatic trial. Through the pilot, we identified, documented, and corrected for challenges encountered while implementing planned study protocols. Per the project's funding mechanism, the ability to move to the larger trial was determined by the achievement of 3 milestones: (1) successful replication of the intervention; (2) demonstrated ability to obtain the necessary sample size; and (3) observe a higher level of engagement in medication for addiction treatment in the POINT group compared to standard care. Overall implementation of the study protocols was successful, with only minor refinements to proposed procedures being required in light of challenges with (1) data access, (2) recruitment, and (3) identification of the expansion hospitals. All three milestones were reached. Challenges in implementing protocols and reaching milestones resulted in refinements that improved the study design overall. The subsequent trial will add to the limited but growing evidence on ED-based peer supports. Capitalizing on STR efforts to study an already scaling and promising intervention is likely to lead to faster and more sustainable results with greater generalizability than traditional, efficacy-focused clinical research.

Original languageEnglish (US)
JournalJournal of Substance Abuse Treatment
DOIs
StatePublished - Jan 1 2019

Fingerprint

Pragmatic Clinical Trials
Clinical Protocols
Opioid Analgesics
Hospital Emergency Service
Aptitude
Naloxone
Sample Size
Therapeutics
Research Personnel
Research
Mentoring

Keywords

  • 21st century cures
  • Medication for addiction treatment
  • Opioid State Targeted Response
  • Opioid use disorder
  • Peer support
  • Pilot study
  • Recovery coach
  • Social emergency medicine

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Replication of an emergency department-based recovery coaching intervention and pilot testing of pragmatic trial protocols within the context of Indiana's Opioid State Targeted Response plan. / Watson, Dennis P.; Brucker, Krista; McGuire, Alan; Snow-Hill, Nyssa L.; Xu, Huiping; Cohen, Alex; Campbell, Mark; Robison, Lisa; Sightes, Emily; Buhner, Rebecca; O'Donnell, Daniel; Kline, Jeffrey.

In: Journal of Substance Abuse Treatment, 01.01.2019.

Research output: Contribution to journalArticle

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