Training Initiative Increases Medication-assisted Treatment for Veterans with Opioid Use Disorder

January 29, 2021

Takeaway: During the two years since the launch of the Stepped Care for Opioid Use Disorder, Train the Trainer (SCOUTT) Initiative, the number of Veterans with OUD who received buprenorphine increased by 164%, and the number of providers prescribing buprenorphine increased by 169%. Work by SCOUTT QUERI is informing expansion of the program to additional sites in FY2021.

Among Veterans receiving VA healthcare, there has been a sharp rise in the number of patients diagnosed with opioid use disorder: from 25,031 in 2003 to 61,420 in 2019. As the largest provider of substance use disorder treatment in the nation, one of VA’s priorities is to improve the care of patients with OUD and to encourage medication treatment for opioid use disorder (MOUD) to improve outcomes, reduce suicidality and OUD harm, and improve coordination of care along the continuum of OUD care. In response, VA’s Office of Mental Health & Suicide Prevention (OMHSP) initiated the Stepped Care for Opioid Use Disorder, Train the Trainer (SCOUTT) Initiative to facilitate access to MOUD in VA non-substance use disorder care settings.

SCOUTT QUERI’s primary goal is to increase MOUD prescribing in VA primary care, mental health, and pain clinics by training providers working in those settings how to provide MOUD – and to facilitate implementation by providing an ongoing learning collaborative. The SCOUTT Initiative’s outcomes may be most applicable to non-substance use disorder (SUD) treatment settings where most patients receive their healthcare. Key measures used to monitor SCOUTT progress include the:

• Number of VA patients with an OUD who were prescribed buprenorphine or injectable naltrexone by implementation clinic prescribers; and
• Number of implementation clinic prescribers who prescribed these medications to patients with an OUD.

Since the launch of the SCOUTT initiative, the number of Veterans with OUD who received buprenorphine increased by 164%, and the number of providers prescribing buprenorphine increased by 169%. This work is informing expansion of the program to additional sites, which began in early FY2021. QUERI SCOUTT investigators are inviting implementation clinic providers from each VISN to participate in interviews to understand provider behavior, patient perspectives on receiving care, and barriers and facilitators to implementing MOUD in non-SUD treatment settings.