| Description |
Methamphetamine is a highly addictive central nervous system stimulant and is associated with several adverse health outcomes. Currently, there is little consensus and few guidelines for treating Methamphetamine Use Disorder (MUD) in primary care, resulting in providers' lack of clinical expertise and knowledge about evidence-based practices to treat MUD. Primary care providers are in an ideal position to assess, treat, and support these patients. Local Problem: The clinic is a Federally Qualified Health Center in urban UT, offering Medication-Assisted Treatment (MAT) to individuals struggling with substance addiction. Methamphetamine users come to the clinic seeking care, but providers lack formal training in current and evidence-based practices to treat this population. This project aimed to tailor an evidence-based toolkit for methamphetamine use disorder (MUD) treatment in adults (18 years and older) and implement it at Utah Partners for Health to facilitate the application of evidence- based interventions. Methods: The Institute for Healthcare Management model provides the framework for this project by implementing a provider-focused MUD toolkit, measuring the frequency of use of the toolkit, seeking input from stakeholders, and adjusting the toolkit through plan, do, study, act (PDSA) cycles. Interventions: A 3-month chart review was completed to estimate the number of patient clinical encounters with MUD. A pre-survey of clinician stakeholders was conducted to assess current knowledge, attitudes, facilitators, and barriers to MUD treatment. A clinic-specific toolkit was tailored and presented to stakeholders. The toolkit included pharmacological and non- pharmacological options for MUD treatment, harm reduction options, clinic workflow models, billing and codes to optimize clinic revenue, and referral resources applicable to the geographic area. During the implementation phase of six weeks, the PDSA cycle was used to identify and make rapid cycle changes as indicated. After the implementation, a post-survey was conducted to identify stakeholder perceptions, attitudes, and knowledge changes and assess the toolkit's feasibility, usability, and satisfaction. A post-intervention chart review was conducted to estimate the frequency of the toolkit's use. Descriptive statistics were used to analyze demographic information, inferential statistics were used for Likert-scale questions, and qualitative analysis was used to analyze changes in pre- and post-intervention data and open-ended questions. Results: All 13 stakeholders who participated in this project responded to the pre-and post- surveys. In addition, 85% reported that the toolkit met their need for education and supportive resources, and 92% reported that it increased their likelihood of initiating MUD screening and treatment. Qualitative feedback reiterated that the toolkit was easy to use, concise, and adapted to the clinic's needs, facilitating the treatment of patients with MUD. Stakeholders reported using the toolkit to provide treatment to 100% (n=8) of new patients with MUD during the implementation period of this project and requested that continuous success stories and challenges be shared with them. Conclusion: This quality improvement project aimed to improve the treatment of adults with MUD in primary care by tailoring a toolkit with best evidence-based practices and implementing it at a primary care clinic. Stakeholders reported that the toolkit increased their likelihood of initiating screening/treatment for MUD. Replication of this project is needed in other primary care settings involving a larger group of stakeholders and clients. |
