Prescription and illicit opioid use drives our nation’s increasing drug-related overdose death rate. Despite evidence as the most effective form of treatment for opioid use disorder, medications for addiction treatment (MAT) such as methadone, buprenorphine, and naltrexone remain underutilized. Recent federally-funded grants aimed at these limitations offer opportunities to explore the influence of specific implementation support strategies on adoption of evidence-based treatments.

The current study examines the differential impact of participation in four common implementation support strategies – Project ECHO (n=14), learning collaboratives (n=7), clinical skills trainings (n=3), and didactic webinars (n=4). Growth in patients initiating buprenorphine among the 178 clinics enrolled in California’s federally-funded MAT expansion project served as the primary outcome. We collected three years of clinic-level attendance patterns at all events. A linear mixed effects model was employed to evaluate whether clinic attendance at events increased patients initiations.

Clinics attending Project ECHO sessions had significantly greater growth in patients initiating buprenorphine than clinics that did not attend (95% CI, 0.06 to 0.25; p < 0.001). Clinics attending learning collaboratives also had significantly greater growth than non-attending clinics (95 % CI, 0.029 to 0.32; p < 0.001). Continued analysis is investigating clinical skills trainings, didactic webinars, and combined effect attendance of all strategy types. Further analysis on the number of staff attending (depth), will be completed to evaluate dose-dependent effects of participation on treatment outcomes.

Multi-component implementation support strategies, Project ECHO and learning collaboratives, employed within California’s MAT expansion project, were associated with increased patients initiating buprenorphine among attending clinics. Prospective and rigorous evaluations are needed to investigate the effectiveness of widely-employed yet understudied implementation support strategies intended to scale-up addiction medications. Understanding strategies that influence the adoption of evidence-based treatments at systems- and practice-level settings is essential in closing persistent gaps in access to care.