TY  - JOUR
PY  - 2024//
TI  - Implementation of medication for opioid use disorder treatment during a natural disaster: The PROUD-LA study
JO  - Journal of substance use and addiction treatment
A1  - Springgate, Benjamin
A1  - Matta, Isha
A1  - True, Gala
A1  - Doran, Hanna
A1  - Torres, Wesley Villavicencio
A1  - Stevens, Elyse
A1  - Holland, Elizabeth
A1  - Mott, Karlee
A1  - Ardoin, Tiffany R.
A1  - Nixdorff, Neil
A1  - Haywood, Catherine
A1  - Meyers, Diana
A1  - Johnson, Arthur
A1  - Tatum, Thad
A1  - Palinkas, Lawrence A.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: The impacts of climate change-related extreme weather events (EWEs) on Medication for Opioid Use Disorders (MOUD) implementation for Medicaid beneficiaries are relatively unknown. Such information is critical to disaster planning and other implementation strategies. In this study we examined implementation determinants and strategies for MOUD during EWEs. <br><br>METHODS: The Louisiana-based Community Resilience Learning Collaborative and Research Network (C-LEARN) utilized Rapid Assessment Procedures-Informed Community Ethnography (RAPICE), involving community leaders in study design, execution, and data analysis. We conducted qualitative semi-structured interviews with 42 individuals, including MOUD Medicaid member patients and their caregivers, healthcare providers and administrators, and public health officials with experience with climate-related disasters. We mapped key themes onto updated Consolidated Framework for Implementation Research domains. <br><br>RESULTS: MOUD use is limited during EWEs by pharmacy closures, challenges to medication prescription and access across state lines, hospital and clinic service limits, overcrowded emergency departments, and disrupted communications with providers. MOUD demand simultaneously increases due to the stress associated with displacement, resource loss, the COVID-19 pandemic, and social determinants of health. Effective implementation strategies include healthcare system disaster plans with protocols for clear and regular patient-provider communication, community outreach, additional staffing, and virtual delivery of services. Providers can also increase MOUD access by having remote access to EHRs, laptops and contact information, resource lists, collaborative networks, and contact with patients via call centers and social media. Patients can retain access to MOUD via online patient portals, health apps, call centers, and provider calls and texts. The impact of EWEs on MOUD access and use is also influenced by individual characteristics of both patients and providers. <br><br>CONCLUSIONS: The increasing frequency and severity of climate-related EWEs poses a serious threat to MOUD for Medicaid beneficiaries. MOUD-specific disaster planning and use of telehealth for maintaining contact and providing care are effective strategies for MOUD implementation during EWEs. Potential considerations for policies and practices of Medicaid, providers, and others to benefit members during hurricanes or major community stressors, include changes in Medicaid policies to enable access to MOUD by interstate evacuees, improvement of medication refill flexibilities, and incentivization of telehealth services for more systematic use.<p />  <p>Language: en</p>
LA  - en
SN  - 2949-8767
UR  - http://dx.doi.org/10.1016/j.josat.2024.209469
ID  - ref1
ER  -