Extension for Community Healthcare Outcomes (ECHO) as a tool for continuing medical education on opioid use disorder and comorbidities

Agley, Jon; Adams, Zachary W.; Hulvershorn, Leslie A.

doi:10.1111/add.14494

Cited by 12 publications

(14 citation statements)

References 13 publications

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“…[51][52][53] Remote education and mentoring programs like Project ECHO (Extension for Community Health Outcomes) may better facilitate practice-level changes, and can be deployed in rural settings. [54][55][56] These programs must also be accompanied by additional resources within the clinics, including expanded access to behavioral health providers. [57][58][59] Three barriers have important implications for screening in rural settings.…”

Section: Discussionmentioning

confidence: 99%

Screening for Substance Use in Rural Primary Care: a Qualitative Study of Providers and Patients

et al. 2019

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BACKGROUND: Substance use frequently goes undetected in primary care. Though barriers to implementing systematic screening for alcohol and drug use have been examined in urban settings, less is known about screening in rural primary care. OBJECTIVE: To identify current screening practices, barriers, facilitators, and recommendations for the implementation of substance use screening in rural federally qualified health centers (FQHCs). DESIGN: As part of a multi-phase study implementing electronic health record-integrated screening, focus groups (n = 60: all stakeholder groups) and individual interviews (n = 10 primary care providers (PCPs)) were conducted. PARTICIPANTS: Three stakeholder groups (PCPs, medical assistants (MAs), and patients) at three rural FQHCs in Maine. APPROACH: Focus groups and interviews were recorded, transcribed, and content analyzed. Themes surrounding current substance use screening practices, barriers to screening, and recommendations for implementation were identified and organized by the Knowledge to Action (KTA) Framework. KEY RESULTS: Identifying the problem: Stakeholders unanimously agreed that screening is important, and that universal screening is preferred to targeted approaches. Adapting to the local context: PCPs and MAs agreed that screening should be done annually. Views were mixed regarding the delivery of screening; patients preferred self-administered, tablet-based screening, while MAs and PCPs were divided between self-administered and face-to-face approaches. Assessing barriers: For patients, barriers to screening centered around a perceived lack of rapport with providers, which contributed to concerns about trust, judgment, and privacy. For PCPs and MAs, barriers included lack of comfort, training, and preparedness to address screening results and offer treatment. CONCLUSIONS: Though stakeholders agree on the importance of implementing universal screening, concerns about the patient-provider relationship, the consequences of disclosure, and privacy appear heightened by the rural context. Findings highlight that strong relationships with providers are critical for patients, while in-clinic resources and training are needed to increase provider comfort and preparedness to address substance use.

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Section: Discussionmentioning

confidence: 99%

Screening for Substance Use in Rural Primary Care: a Qualitative Study of Providers and Patients

et al. 2019

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“…One model that has proven useful in helping such providers serve vulnerable and dispersed populations is the model promoted by Project ECHO (Extension for Community Healthcare Outcomes) . By engaging frontline service providers with a continuous learning system and specialist mentors, it can dramatically increase the access of PWID to HCV care and treatment .…”

Section: What Who and Howmentioning

confidence: 99%

We know DAAs work, so now what? Simplifying models of care to enhance the hepatitis C cascade

et al. 2019

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“…18,19 Indiana's Teen Vaping ECHO Program ECHO programs and accompanying publications have covered treatment of substance use disorders (ie, opioids), including in Indiana. 25 However, as of August 2021, no ECHO programs have directly addressed adolescent vaping. 20 To bridge this gap in application of up-to-date learning approaches to an important clinical and public health concern, the Indiana Teen Vaping ECHO program was developed in 2020 and led by a partnership between clinical specialists at the Indiana University School of Medicine (IUSM) and the Indiana State Department of Health (IDOH).…”

Section: Specialized Clinical Learning Through Project Echomentioning

confidence: 99%

Examining the Efficacy of Project ECHO to Improve Clinicians’ Knowledge and Preparedness to Treat Adolescent Vaping

Oliver

Bell

Agley

et al. 2022

Clin Pediatr (Phila)

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As adolescent vaping reaches epidemic rates in the United States, it is imperative that pediatric clinicians have access to medical knowledge on best practices for screening, assessing, and treating vaping-related substance use. The Teen Vaping ECHO (Extension for Community Healthcare Outcomes) program was developed to offer practical learning sessions focused on clinical management of adolescent vaping. This study describes the development, implementation, and evaluation of the program’s impact on participants’ knowledge, attitudes, and practices regarding treatment of adolescent vaping from registration to the end of the series. Participants were generally knowledgeable about vaping at registration and reported significant increases in comfort talking with patients about vaping, counseling patients on nicotine replacement products, and frequency of implementing best-practice screening strategies at the end of the series. This study suggests ECHO programs focused on improving clinical management of adolescent vaping may increase accessibility of evidence-based care and reduce harms associated with vaping in youth.

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Extension for Community Healthcare Outcomes (ECHO) as a tool for continuing medical education on opioid use disorder and comorbidities

Cited by 12 publications

References 13 publications

Screening for Substance Use in Rural Primary Care: a Qualitative Study of Providers and Patients

Screening for Substance Use in Rural Primary Care: a Qualitative Study of Providers and Patients

We know DAAs work, so now what? Simplifying models of care to enhance the hepatitis C cascade

Examining the Efficacy of Project ECHO to Improve Clinicians’ Knowledge and Preparedness to Treat Adolescent Vaping

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