Date of Graduation

5-2024

Document Type

Capstone

Keywords

Opioid use disorder; Medication--assisted treatment; Social determinants of health

Degree Name

Doctor of Nursing Practice (DNP)

Degree Level

Graduate

Advisor/Mentor

Kilmer, Michele R.

Committee Member

Ballentine, Hope A.

Abstract

Introduction: Medication-assisted treatment (MAT) is considered the most effective treatment for patients with opioid use disorder (OUD); however, MAT program retention rates are consistently low across the United States. Addressing social determinants of health (SDOH) through text message could impact MAT retention; therefore, a pilot project at a federally qualified healthcare center (FQHC) was implemented.

Methods: The Protocol for Responding to and Assessing Patients’ Assets, Risk, and Experiences (PRAPARE) SDOH screening tool was implemented for patients undergoing MAT for OUD. Community resource referrals were provided via text message based on the screening results. Retention in treatment was measured by prescriptions filled without a gap of more than seven days for four consecutive months.

Results: Fourteen of the 28 patients reported SDOH barriers on the PRAPARE instrument in the first month. The rate of continuous pharmacotherapy for OUD without a gap of more than seven days (96%) was significantly increased in the experimental group (M = .96, SD = .19) as compared to the control group six months prior (22%) (t = 15.61, p = 1.4806E-26) by the second month. The retention rate was significantly increased in the experimental group (82%) (M = .82, SD = .39) when compared to the control group (t = 7.39, p = 5.34E-9) during the third month. The retention rate was significantly increased in the experimental group (61%) (M = .64, SD = .48) as compared to the control group (t = 5.19, p= 1.25E-5) during the fourth month.

Conclusions: MAT retention can be increased by identifying and addressing SDOH barriers with community resource referrals via text message.

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