Implementation Outcomes
Implementation outcomes are measures of how well and how often methadone is being implemented. Health outcomes are measures of whether methadone works. Click the buttons on the left to read more about implementation outcomes and health outcomes that have been measured for methadone, as well as to consider some potential research questions. In addition, view the RASC guide Integrating Implementation Outcomes into Effectiveness Studies for practical guidance on how to include implementation outcomes in your studies.
While there is robust literature on the effectiveness of methadone, there are far fewer studies on how to implement it. The few studies that have reported on the implementation of methadone and other medications for opioid use disorder have shown that proactive implementation support can help organizations and healthcare professionals to adopt methadone and effectively reach patients.
Adoption is assessed from the perspective of the individual or organization delivering the intervention. In the CATCH implementation trial of six New York public hospitals, adoption was measured as the proportion of hospitals that ordered an addiction team consult for at least 50% of patients, with the goal of linking the patient to long-term medication for opioid use disorder treatment with methadone, buprenorphine, or extended-release naltrexone post-discharge. Preliminary estimates indicate that four of the six hospitals had adopted the addiction team consult process, suggesting that intentional implementation support can promote adoption of methadone and other medications for opioid use disorder.
Reach is assessed from the perspective of the individual receiving the intervention. For methadone-related implementation efforts, in the CATCH implementation trial of six New York public hospitals, the proportion of all patients hospitalized for an opioid-related diagnosis who had at least one medication for opioid use disorder (methadone, buprenorphine, or extended-release naltrexone) after receiving implementation support ranged from 49.1% to 71.8%. In a trial of external coaching vs ECHO telementoring to implement medications for opioid use disorder (MOUD) in 38 jails, implementation efforts supported an additional 23 inmates receiving MOUD per year during the intervention phase. These studies suggest that intentional implementation support increases both the number and proportion of patients receiving methadone and other medications for opioid use disorder.