Addiction Medicine Practice-Based Research Network (AMNet): Assessment Tools and Quality Measures

Abstract

Introduction

The need for innovative approaches to address the opioid epidemic in the United States is widely recognized. Many challenges exist to addressing this epidemic, including the obstacles outpatient substance use treatment practices face in implementing measurement-based care (MBC), quality measurement systems, and evidence-based treatments. Also, there are insufficient opportunities for clinicians in these settings to participate in research, resulting in diminished translation of research findings into community-based practice. To address these challenges, the Addiction Medicine Practice-Based Research Network (AMNet) was developed to facilitate the uptake of MBC in outpatient practices via implementation of patient-reported assessments and quality of care performance measures to improve patient outcomes. This network will offer clinicians in outpatient settings (not incuding opioid treatment programs [OTPs]) the opportunity to participate in future substance use disorder treatment research studies.

Methods

A key step in the development of AMNet was the selection of substance use-specific assessment tools and quality of care performance measures for incorporation into the American Psychiatric Association’s mental health patient registry, PsychPRO. A scoping review and multi-step consensus-based process were used to identify, review and select candidate assessment tools and quality of care performance measures for opioid use disorders (OUD) and substance use disorders (SUD).

Results

Following a consensus-based methodology, 12 standardized assessment tools and 3 quality of care performance measures for OUD and SUD were selected to help facilitate the implementation of MBC and quality improvement for AMNet participants. These tools were further categorized as core and optional.

Conclusion

By offering a collection of carefully vetted assessment tools and quality measures through PsychPRO, AMNet will help participating clinicians with the systematic uptake of MBC and delivery of evidence-based treatment for patients with SUD. Also, AMNet will act as a centralized repository of data collected from patients and clinicians in non-OTP outpatient addiction medicine practices and serve as a platform for opioid treatment research.

Keywords:

• measurement-based care
• addiction medicine
• patient-reported outcome measures
• quality measures
• quality improvement

Ethics Approval and Informed Consent

The AMNet protocol was reviewed and approved by the APA’s Institutional Review Board (IRB). Because clincians' particpation in AMNet is a quality improvement activity and based on the revised common rule,⁶⁴ the IRB determined that patients' informed consent was not needed.

Disclosure

Dr. Clarke serves on the Mental Health Landscape Project Advisory Panel for RAND Corporation: a project funded by Otsuka Pharmaceuticals that is not related to the present paper. Dr. Clarke reports grants, non-financial support from National Institute on Drug Abuse (NIDA), Agency for Healthcare Research and Quality, and Health and Human Services Center for Medicare and Medicaid Services (CMS) during the conduct of the study. Dr. Schwartz reports providing consultation to Verily Life Sciences, grants from NIDA, during the conduct of the study. He is PI of a NIDA-funded study that is receiving free medication from Indivior and Alkermes. Dr. Vocci reports receiving free medication from Alkermes and Braeburn Pharma for clinical studies. Dr. Vocci has also received meals from Braeburn Pharma. Dr. Vocci has consulted with and received meals and travel reimbursements from Lyndra Pharmaceuticals and Takeda Pharmaceuticals and a group of generic buprenorphine manufacturers. Dr. Vocci also received meals and travel reimbursement from Intratab Labs. Ms Ibrahim reports non-financial grant support from NIDA during the conduct of the study. Dr. Doty reports non-financial grant support from NIDA and CMS during the conduct of the study. Ms Patel reports non-financial grant support from NIDA during the conduct of the study. Ms Thompson reports non-financial grant support from NIDA and CMS during the conduct of the study.

Additional information

Funding

This project was made possible by grant number 3U01DA046910-02S2 from the National Institute on Drug Abuse at the National Institutes of Health, with funding from the Office of the Secretary Patient Centered Outcomes Research Trust Fund (Interagency Agreement Number 750120PE080047). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health or the US Department of Health and Human Services.