Evaluation of a primary care-based Medication for Opioid Use Disorder (MOUD) program in a fully-integrated federally qualified health center

Abstract

Introduction

Clackamas Health Centers (CHC), a public sector Federally Qualified Health Center in Oregon, has been providing medication for opioid use disorder (MOUD) in a low-barrier, harm reduction model for over a decade. CHC also provides a unique pathway for criminal justice-involved patients to receive MOUD treatment. CHC's primary care-based treatment program has seen substantial growth since it began; however, a comprehensive review has never been completed.

Methods

A mixed-methodology program evaluation was undertaken to determine if the CHC MOUD program is providing effective low-barrier care. Outcomes for this evaluation included retention rate, opioid-free urine drug screen (UDS) results, patient and provider satisfaction, and patient improvement in quality of life.

Results

Data collected from July 1, 2022 to December 31, 2022 showed a 6-month retention rate of 85 % (N = 186). Urine drug screens were opioid-negative for 91 % of samples examined (N = 222). Patients reported positive lifestyle changes after receiving MOUD treatment, demonstrated by Treatment Effectiveness Assessment scores. Medical providers surveyed (N = 9) felt satisfied in their work treating patients with opioid use disorder and patients (N = 24) reported satisfaction with the care they were receiving in the MOUD program.

Conclusion

While data on primary care-based MOUD models is sparse, this evaluation has shown similar or better results than those noted in other studies on outcomes such as retention and urine drug screen results. These data can help demonstrate the effectiveness of fully-integrated MOUD programs in primary care, as well as establishing a baseline for treatment outcomes and future program evaluation.