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Research ArticleOriginal Research

Increasing Primary Care Utilization of Medication-Assisted Treatment (MAT) for Opioid Use Disorder

Stacey L. Gardner-Buckshaw, Adam T. Perzynski, Russell Spieth, Poojajeet Khaira, Chris Delos Reyes, Laura Novak, Denise Kropp, Aleece Caron and John M. Boltri
The Journal of the American Board of Family Medicine March 2023, jabfm.2022.220281R2; DOI: https://doi.org/10.3122/jabfm.2022.220281R2
Stacey L. Gardner-Buckshaw
From the Department of Family and Community Medicine, Northeast Ohio Medical University (SGB); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University, Cleveland, OH (ATP); Adult Behavioral Health, The Centers, Cleveland, OH (RS); Department of Psychiatry, The MetroHealth System, Cleveland, OH (PK); Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH (CDR); Summa Health, Barberton Family Medicine Residency Program, Cleveland, OH (LN); Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH (DK); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University (AC); Department of Family and Community Medicine, Northeast Ohio Medical University (JMB).
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Adam T. Perzynski
From the Department of Family and Community Medicine, Northeast Ohio Medical University (SGB); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University, Cleveland, OH (ATP); Adult Behavioral Health, The Centers, Cleveland, OH (RS); Department of Psychiatry, The MetroHealth System, Cleveland, OH (PK); Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH (CDR); Summa Health, Barberton Family Medicine Residency Program, Cleveland, OH (LN); Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH (DK); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University (AC); Department of Family and Community Medicine, Northeast Ohio Medical University (JMB).
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Russell Spieth
From the Department of Family and Community Medicine, Northeast Ohio Medical University (SGB); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University, Cleveland, OH (ATP); Adult Behavioral Health, The Centers, Cleveland, OH (RS); Department of Psychiatry, The MetroHealth System, Cleveland, OH (PK); Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH (CDR); Summa Health, Barberton Family Medicine Residency Program, Cleveland, OH (LN); Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH (DK); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University (AC); Department of Family and Community Medicine, Northeast Ohio Medical University (JMB).
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Poojajeet Khaira
From the Department of Family and Community Medicine, Northeast Ohio Medical University (SGB); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University, Cleveland, OH (ATP); Adult Behavioral Health, The Centers, Cleveland, OH (RS); Department of Psychiatry, The MetroHealth System, Cleveland, OH (PK); Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH (CDR); Summa Health, Barberton Family Medicine Residency Program, Cleveland, OH (LN); Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH (DK); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University (AC); Department of Family and Community Medicine, Northeast Ohio Medical University (JMB).
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Chris Delos Reyes
From the Department of Family and Community Medicine, Northeast Ohio Medical University (SGB); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University, Cleveland, OH (ATP); Adult Behavioral Health, The Centers, Cleveland, OH (RS); Department of Psychiatry, The MetroHealth System, Cleveland, OH (PK); Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH (CDR); Summa Health, Barberton Family Medicine Residency Program, Cleveland, OH (LN); Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH (DK); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University (AC); Department of Family and Community Medicine, Northeast Ohio Medical University (JMB).
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Laura Novak
From the Department of Family and Community Medicine, Northeast Ohio Medical University (SGB); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University, Cleveland, OH (ATP); Adult Behavioral Health, The Centers, Cleveland, OH (RS); Department of Psychiatry, The MetroHealth System, Cleveland, OH (PK); Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH (CDR); Summa Health, Barberton Family Medicine Residency Program, Cleveland, OH (LN); Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH (DK); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University (AC); Department of Family and Community Medicine, Northeast Ohio Medical University (JMB).
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Denise Kropp
From the Department of Family and Community Medicine, Northeast Ohio Medical University (SGB); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University, Cleveland, OH (ATP); Adult Behavioral Health, The Centers, Cleveland, OH (RS); Department of Psychiatry, The MetroHealth System, Cleveland, OH (PK); Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH (CDR); Summa Health, Barberton Family Medicine Residency Program, Cleveland, OH (LN); Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH (DK); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University (AC); Department of Family and Community Medicine, Northeast Ohio Medical University (JMB).
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Aleece Caron
From the Department of Family and Community Medicine, Northeast Ohio Medical University (SGB); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University, Cleveland, OH (ATP); Adult Behavioral Health, The Centers, Cleveland, OH (RS); Department of Psychiatry, The MetroHealth System, Cleveland, OH (PK); Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH (CDR); Summa Health, Barberton Family Medicine Residency Program, Cleveland, OH (LN); Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH (DK); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University (AC); Department of Family and Community Medicine, Northeast Ohio Medical University (JMB).
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John M. Boltri
From the Department of Family and Community Medicine, Northeast Ohio Medical University (SGB); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University, Cleveland, OH (ATP); Adult Behavioral Health, The Centers, Cleveland, OH (RS); Department of Psychiatry, The MetroHealth System, Cleveland, OH (PK); Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH (CDR); Summa Health, Barberton Family Medicine Residency Program, Cleveland, OH (LN); Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH (DK); Center for Health Care Research and Policy within The MetroHealth System, Case Western Reserve University (AC); Department of Family and Community Medicine, Northeast Ohio Medical University (JMB).
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    Figure 1.

    Pre–post comparison of willingness, comfort, and confidence with medication-assisted treatment (MAT).

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    Figure 2.

    Pre–post comparison of importance and confidence items, care process and patient interactions.

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    Appendix Figure 1.

    Scree plots from exploratory factor analyses of pre-test medication-assisted treatment (MAT) importance and confidence measures.

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    Table 1.

    Exploratory Factor Analysis Loadings for Medication-Assisted Treatment (MAT) Importance and Confidence Items

    Importance itemsConfidence items
    Care processPatient interactionCare processPatient interaction
    Implementing Buprenorphine opioid treatment, managing its long-term maintenance on medications0.870.91
    Matching patients to appropriate MAT medications (methadone, buprenorphine, naltrexone)0.860.89
    Defining goals of MAT with patients0.830.88
    Implementing Naltrexone opioid treatment, managing its long-term maintenance on medications0.800.88
    Discussing MAT medication effects and side effects with patients0.780.84
    Detailing MAT approaches (methadone, buprenorphine, naltrexone) and medication protocols for opioid use disorders with patients0.780.84
    Treating specialized populations with MAT0.730.84
    Discussing the effectiveness of MAT for opioid use disorders with patients0.720.79
    Familiarizing patients with laws, regulations and oversights involved with agonist-based and partial agonist treatments0.690.78
    Using reflective listening0.990.99
    Using open body language0.860.89
    Demonstrating assertive compassion0.770.78
    • Notes: Extraction method was maximum likelihood; rotation method was Promax with Kaiser normalization. Loadings <0.20 are not shown. All loadings are from the pattern matrix.

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    Table 2.

    Reliability Analysis for Pre- and Post- MAT Training Evaluation Items (Cronbach's α)

    ItemsPrePost
    Confidence
    Care process (n = 9)0.960.93
    Patient interaction (n = 3)0.920.94
    Importance
    Care process (n = 9)0.940.95
    Patient interaction (n = 3)0.920.96
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The Journal of the American Board of Family     Medicine: 38 (1)
The Journal of the American Board of Family Medicine
Vol. 38, Issue 1
January-February 2025
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Increasing Primary Care Utilization of Medication-Assisted Treatment (MAT) for Opioid Use Disorder
Stacey L. Gardner-Buckshaw, Adam T. Perzynski, Russell Spieth, Poojajeet Khaira, Chris Delos Reyes, Laura Novak, Denise Kropp, Aleece Caron, John M. Boltri
The Journal of the American Board of Family Medicine Mar 2023, jabfm.2022.220281R2; DOI: 10.3122/jabfm.2022.220281R2

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Increasing Primary Care Utilization of Medication-Assisted Treatment (MAT) for Opioid Use Disorder
Stacey L. Gardner-Buckshaw, Adam T. Perzynski, Russell Spieth, Poojajeet Khaira, Chris Delos Reyes, Laura Novak, Denise Kropp, Aleece Caron, John M. Boltri
The Journal of the American Board of Family Medicine Mar 2023, jabfm.2022.220281R2; DOI: 10.3122/jabfm.2022.220281R2
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  • Disease Management
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