Boost for Oral Opioid Agonist Therapy

Although opioid agonist treatment is effective in treating opioid use disorders, retention in such treatment is suboptimal in part due to quality of care issues. A new initiative sought to boost treatment of opioid use disorders so that people stay there longer. This article describes how teams did in a structured quality improvement initiative in Vancouver, Canada.

Best Practice Oral Opioid Agonist Therapy Collaborative

The Best-practice in Oral Opioid agoniSt Therapy – or the BOOST – was a 24-month Breakthrough Series Collaborative which is a model of the Institute for Healthcare Improvement.

It was the first program of its kind in Canada and was among the latest efforts to turn the tide on the opioid crisis. It aimed to improve care for people living with opioid use disorder in Vancouver by implementing, measuring and sharing best practices.

We looked at electronic medical record (EMR) chart data to find patients with a documented diagnosis of opioid addiction. For those who had this diagnosis, or who were suspected of having opioid addiction, we looked at their age, gender and housing information.

What did the BOOST change?

17 health care teams participated in this study. They were caring for a total of 4301 patients with a documented diagnosis of opioid addiction. The mean age of patients was 43, with 64% identifying as male, 35% female and 1% trans or non-binary. The majority of patients lived in the Vancouver region (76%) and half of them had Most Responsible Provider – MRP. While typically referring to a physician, this may include a nurse practitioner or other healthcare professional.

The implementation scores showed that the majority of (59%) teams made some improvement throughout the Collaborative.

 Why is quality improvement important?

Descriptive data from the evaluation of this initiative illustrates its success. Most participants with an active prescription stayed in care. As such, this evidence supports the use of quality improvement to close gaps in opioid care processes and treatment outcomes. Finally, this system-level approach has been spread across British Columbia, and other jurisdictions facing similar overdose crises can use it too.

Find more info about the collaborative online here: http://stophivaids.ca/STOP/wp-content/uploads/post/BOOST-Collaborative-Change-Package.pdf).

Citation: Beamish, L., Sagorin, Z., Stanley, C., English, K., Garelnabi, R., Cousineau, D., Barrios, R., Klimas, J. (2019) Implementation of a regional quality improvement collaborative to improve care of people living with opioid use disorder in a Canadian setting. BMC Health Services Research (2019) 19:663 https://doi.org/10.1186/s12913-019-4472-8

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