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ORIGINAL RESEARCH article

Front. Med.
Sec. Family Medicine and Primary Care
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1450672

Increasing Medication Assisted Treatment in Rural Primary Care Practice: A Qualitative Comparative Analysis from IT MATTTRs Colorado

Provisionally accepted
Jodi Holtrop Jodi Holtrop 1*Rebecca Mullen Rebecca Mullen 1Kristen Curcija Kristen Curcija 1Claude Rubinson Claude Rubinson 2John Westfall John Westfall 1,3Donald Nease Donald Nease 1Linda Zittleman Linda Zittleman 1
  • 1 Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, United States
  • 2 Social Sciences, University of Houston–Downtown, Houston, Texas, United States
  • 3 DARTNet Institute, Aurora, Colorado, United States

The final, formatted version of the article will be published soon.

    Purpose: Opioid dependence and use disorders (OUDs) are serious public health crises resulting in a rising number of opioid-related deaths. Medication assisted treatment (MAT), in this case treatment with buprenorphine, is an evidence-based solution to combatting OUD; however, MAT has been largely unavailable in rural areas. This study investigated what it took to increase MAT in rural Colorado primary care practices. Methods: Mixed methods study using qualitative and quantitative data collected from interviews, observations, surveys, and practice-reported data. Participants were staff members from 35 rural primary care practices in Colorado, USA. We qualitatively analyzed the data, then transformed the data, then analyzed it using qualitative comparative analysis (QCA). Results: Having a MAT waivered prescribing clinician on staff and a MAT system in place were necessary conditions to providing MAT (consistency = 1.0; coverage = 0.53 & 0.39 respectively). Practice size (number of providers) was associated with differences in conditions that provided sufficient aspects for MAT provision. Small (1-2 medical providers), non-private practices benefited from the presence of behavioral health and a clinician with MAT experience. Medium sized practices (3-5 providers) whether private or not benefited from behavioral health, often in combination with a clinician with MAT experience. In large practices (6 or more providers), behavioral health was not a factor while having a clinician with MAT experience mattered half of the time. Conclusions: Implementation of MAT in rural primary care is a complex task that may benefit from the resources of behavioral health and a clinician with prior MAT experience.

    Keywords: Opioid use disorder, Rural primary care, Qualitative Comparative Analysis, medication assisted, qualitative research

    Received: 17 Jun 2024; Accepted: 06 Sep 2024.

    Copyright: © 2024 Holtrop, Mullen, Curcija, Rubinson, Westfall, Nease and Zittleman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jodi Holtrop, Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.