MOUD Plus: counseling and peer support to help people with opioid use disorder stay on buprenorphine in primary care
Designing Intensive Primary Care Interventions to Improve Addiction Treatment for Medically and Socially Complex Patients: The "MOUD PLUS (MOUD+)" Study
This pilot will test whether adding on-site counseling and coordinated peer recovery support helps adults with opioid use disorder and other medical problems stay engaged in primary care and remain on buprenorphine.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 70 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Oregon Health and Science University Academic / other |
| Locations | 1 site (Portland, Oregon) |
| Trial ID | NCT06837662 on ClinicalTrials.gov |
What this trial studies
This pilot randomized controlled trial will enroll about 70 adults seen in primary care at Central City Concern in Portland and randomize them to a team-based "MOUD Plus" intervention or to usual low-threshold buprenorphine care. MOUD Plus adds an integrated substance use counselor, coordinated referrals to community peer recovery organizations, and enhanced care coordination and panel management to standard primary care buprenorphine services. Participants are followed to compare retention on medications for opioid use disorder and engagement in primary care between the two arms. The trial tests whether these added supports improve continued MOUD use and primary care engagement among medically complex patients.
Who should consider this trial
Good fit: Adults (18+) with opioid use disorder or recent heroin/fentanyl use who are starting or recently restarted MOUD, have recent return-to-use, and receive primary care at Central City Concern with some medical complexity are ideal candidates.
Not a fit: Patients who are stable on MOUD with no recent return-to-use, those not receiving care at the participating clinic, or those unwilling or unable to engage with counseling or peer services are unlikely to gain extra benefit from this intervention.
Why it matters
Potential benefit: If successful, the approach could help people with OUD and complex medical needs stay in care and on buprenorphine, lowering the risk of overdose and improving overall health.
How similar studies have performed: Similar team-based care models and peer support programs have shown promise for improving engagement and retention on MOUD, but randomized data specifically in medically complex primary care populations are limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Eligibility/Inclusion Criteria. For Aim 3, criteria we seek to recruit include: * Patient participants 18 years and older * Have an OUD-related diagnosis (e.g. Opioid Use Disorder in remission, Opioid Dependence, Opioid Abuse, Substance Use Disorder - opioids, etc.), or have used fentanyl or heroin over the past 30 days * Who meet at least one of the following criteria: * Present to primary care at Central City Concern (CCC) within 8 weeks of starting or re-starting a treatment episode (defined as starting MOUD after not having received prescribed MOUD in an outpatient setting for OUD in the prior 30 days). * Who present to primary care at CCC and are not seeking treatment with MOUD and have not engaged in counseling services (e.g. harm reduction counseling) in the prior 30 days * Have been receiving MOUD in prior 30 days but had a return to use (used fentanyl or heroin) within the past 30 days * Medical complexity (e.g. self-reported or verified in patient's electronic health record) * Have access to phone and/or computer for follow-up activities * Desire to engage in counseling and/or peer services Exclusion Criteria: * Patient participants who present for addiction treatment but are ineligible to receive on-going services at Central City (i.e. they have existing primary care at another location, or are currently receiving opioid use disorder treatment at another clinic, such as methadone clinic) may not participate in the study. * Patient participants who are not able to verbally consent may not participate in the study. * Patients who do not have addiction to opioids may not participate in the study. * Patients who participated in Aim 2 would not be eligible for Aim 3 * Patients who lack stable phone access may not participate in the study.
Where this trial is running
Portland, Oregon
- Central City Concern — Portland, Oregon, United States (Recruiting)
Study contacts
- Principal investigator: Brian Chan, MD MPH — Oregon Health and Science University
- Study coordinator: Study Coordinator
- Email: cheslocm@ohsu.edu
- Phone: 503-346-3043
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.