Adoption is assessed from the perspective of the individual or organization delivering the intervention. For buprenorphine, this could be the number of organizations or the number of individual prescribers within an organization that intend or attempt to administer or prescribe buprenorphine, or the number of organizations who agree to participate in a larger implementation effort to increase buprenorphine prescribing. 

In the CATCH implementation trial at 6 New York public hospitals, adoption was defined as the proportion of participating hospitals that ordered an addiction medicine team consult for at least 50% of patients. This study reported that 4 of 6 hospitals met this adoption target. Alternatively, adoption could be defined as the proportion of target organizations (jails, hospitals) or the proportion of target health professionals (doctors, nurses) who ultimately participate in an implementation effort to provide medications for opioid use disorder. 

Reach is assessed from the perspective of the individual receiving the intervention. For buprenorphine implementation efforts, this is typically the proportion of individuals served by an organization that receive buprenorphine.

In the CATCH implementation trial at 6 New York public hospitals, reach was defined as the proportion of all patients hospitalized for an opioid-related diagnosis who had at least one MOUD (methadone, buprenorphine, or extended-release naltrexone) ordered during hospitalization; reach among the 6 hospitals ranged from 49.1% to 71.8%. In the START randomized trial of an addiction medicine consultation service, reach was defined as the proportion of hospitalized patients who received at least one MOUD prior to hospital discharge; reach among patients randomized to receive an addiction medicine consultation was 57.3% compared to 26.7% among patients randomized to usual care.

Feasibility can be assessed from the perspective of either the individual delivering the intervention (for example, prescribers in an organization) or the individual receiving the intervention (for example, individuals thought to benefit from buprenorphine). Feasibility is defined as the extent to which an intervention can be successfully used within a given service context. This is particularly applicable to buprenorphine, as implementation efforts commonly seek to integrate buprenorphine prescribing into new service contexts where it has not previously been offered. 

Feasibility is inconsistently reported in the buprenorphine implementation literature, with many studies describing feasibility as a measure of overall study success (for example, successfully enrolling participants, prescribing buprenorphine, or collecting data) or by patient quotes about their thoughts about buprenorphine. While these outcomes do describe aspects of feasibility,, we recommend using a validated survey to measure the formal implementation outcome of feasibility, such as the Feasibility of Intervention Measure (FIM). 

Acceptability is assessed from the perspective of either the individual delivering the intervention (for example, prescribers in an organization) or the individual receiving the intervention (for example, individuals thought to benefit from receiving buprenorphine). Acceptability is defined as the perception that a given service is agreeable, palatable, or satisfactory. This is typically measured before a buprenorphine program is implemented in a new service context.

Acceptability is often inconsistently reported in the literature, with many studies describing acceptability as a measure of overall study success (for example, successfully enrolling patients, prescribing buprenorphine, or collecting data on health outcomes) or by patient quotes about their thoughts about buprenorphine. In future work, we recommend using a validated survey if measuring the formal implementation of acceptability, such as the Acceptability of Intervention Measure (AIM).