@article{TEXTUAL,
      recid = {5108},
      author = {Pashchenko, Oleksandra and Bromberg, Daniel J. and  Dumchev, Kostyantyn and LaMonaca, Katherine and Pykalo,  Iryna and Filippovych, Myroslava and Esserman, Denise and  Polonsky, Maxim and de Leon, Samy J. Galvez and Morozova,  Olga and Dvoriak, Sergii and Altice, Frederick L.},
      title = {Preliminary analysis of self-reported quality health  indicators of patients on opioid agonist therapy at  specialty and primary care clinics in Ukraine: A randomized  control trial},
      journal = {PLOS Global Public Health},
      address = {2022-11-02},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;International agencies recommend integrating addiction  treatment into primary care for people who inject drugs  (PWID) with opioid use disorder (OUD). Empirical data  supporting integration that incorporates comprehensive  health outcomes, however, are not known. For this  randomized controlled trial in Ukraine, adult PWID with OUD  were randomized to receive opioid agonist therapy (OAT) in  specialty addiction treatment clinics (SATC) or to primary  care clinics (PCCs). For those randomized to PCC, they were  subsequently allocated to PCCs where clinicians received  pay-for-performance (P4P) incentives (PCC with P4P) or not  (PCC without P4P). Participating cities had one of each of  the three intervention sites to control for geographic  variation. Ongoing tele-education specialty training (OAT,  HIV, tuberculosis) was provided to all PCCs. While the  primary outcome for the parent trial focuses on patient  medical record data, this preliminary analysis focuses on  assessment of self-reported achievement of nationally  recommended quality health indicators (QHIs) which is  summed as a composite QHI score. Secondary outcomes  included specialty and primary care QHI subscores. This  study occurred from 01/20/2018-11/1/2020 with 818 of 990  randomized participants having complete self-reported data  for analysis. Relative to SATC (treatment as usual), the  mean composite QHI score was 12.7 (95% CI: 10.1–15.3;  p&lt;0.001) percentage points higher at PCCs; similar and  significantly higher scores were observed in PCCs compared  to SATCs for both primary care (PCC vs SATC: 18.4 [95% CI:  14.8–22.0; p&lt;0.001] and specialty (PCC vs SATC: 5.9 [95%  CI: 2.6–9.2; p&lt;0.001] QHI scores. Additionally, the mean  composite QHI score was 4.6 (95% CI: 2.0–7.2; p&lt;0.001)  points higher in participants with long term (&gt;3 months)  experience with OAT compared to participants newly  initiating OAT. In summary, PWID with OUD receive greater  primary care and specialty healthcare services when  receiving OAT at PCCs supported by tele-education relative  to treatment as usual provided in SATCs.&lt;/p&gt; &lt;p&gt;Clinical  trial registration: This trial was registered at  clinicaltrials.gov and can be found using the following  registration number: &lt;a  href="https://clinicaltrials.gov/ct2/show/NCT04927091"  target="_blank"&gt;NCT04927091&lt;/a&gt;.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/5108},
}