Medication Assisted Treatment Enrollment for the Marana Health Center

Abstract

Purpose: The purpose of this quality improvement project was to present the ASI for adoption as an integral part of the MAT enrollment and assessment protocol at one federally funded healthcare center in Southern Arizona. Background: Deaths related to opioids have reached epidemic proportions in the United States. From 2000 to 2014, the percentage of fatalities related to opioid increased by 200%. Some 4-6% of those who misuse an opioid prescription will become heroin addicts. One treatment model that has worked is the medication-assisted treatment (MAT); it combines FDA approved medications and counseling to treat substance abuse. Treatment requires at least 12 months to be effective. To establish how compliant patients will be to achieve remission, we must determine how severe the patient believes their addiction is and factors affecting treatment. A tool that addresses this is the Addiction Severity Index (ASI). Method: This QI project was a description of the outcome of a change proposal using the PDSA model. The design was a pre-/post-test with an educational intervention followed by a secondary post-test at 30 days. Health Care Providers within a rural clinic Southern Arizona participated in an educational intervention through a one-day in-service followed by a 30-day trial of the ASI. The pre-test was administered prior to the in-service to identify knowledge base. This was followed by the intervention and the first post-test. The second post-test was administered after the 30 days trial implementation to evaluate change. Results: Thirty-eight invitees attended the in-service. Twenty-eight respondents completed the initial post-test (74%). After the 30 days follow-up, 38 people were sent the questionnaire forms based on the previous attendance record, and 13 responded (21%) responded. Results were positive for the ASI tool as useful within the setting. The consensus from the in-service and 30 days follow up is that the ASI is cost-effective and efficient for enhancing MAT treatment. Conclusion: The implementation of the ASI was successful, as evidenced by its current use. ASI is now being used within the clinic for addiction patients. However, without a sustainability strategy, it may not continue to be used as an enrollment tool.