Challenges of addressing opioid use disorder in rural settings: A state perspective.

Rural states and communities continue to face significant challenges as they work to address the ongoing opioid epidemic and to implement specific strategies for prevention and treatment of opioid use disorder (OUD) and other substance use disorders (SUDs). While a growing number of innovative strategies have been identified that can offer promise for rural communities, state and clinical leaders from rural communities will need to identify evidence-based approaches that can work best in their communities, and ways to tailor options to meet their unique needs. This article identifies a set of five considerations for rural states and communities as they continue their work to identify solutions to this deadly epidemic.

Supporting Physicians and Practice Teams in Efforts to Address the Opioid Epidemic.

Primary care physicians and practice teams increasingly recognize the need to take a role in addressing the growing epidemic of opioid use disorder (OUD) and opioid-related drug overdose deaths, but face considerable challenges in doing so. Through its work supporting practice transformation efforts, sharing innovations, and connecting key sectors within communities, the Network for Regional Healthcare Improvement and several of its member regional health improvement collaboratives have identified innovative ways to support physicians and practice teams in transforming practice in ways that address a spectrum of issues related to opioid use. These strategies include efforts to prevent, identify, and treat opioid addiction, including reducing inappropriate prescribing; improving opioid prescribing safety; compassionately tapering chronic and/or high-dose opioid regimens; appropriately screening for and identifying OUD; initiating treatment with evidence-based medications for OUD within practice settings; and prescribing life-saving naloxone to reverse opioid overdose. By outlining specific initiatives and practice transformation efforts that several regional health improvement collaboratives across the country have implemented to support clinicians and their teams, this article offers examples of how clinicians can get support from collaboratives in their region to implement practice improvement efforts to advance this critically important work.

Rural communities improving quality through collaboration: the MaineHealth story.

Small and rural communities face unique challenges in improving healthcare quality. To address these challenges, MaineHealth, an integrated health system serving small and rural communities, leveraged knowledge, resources, and data through collaboration to help providers improve care and outcomes for asthma, heart failure, diabetes, and depression. The programs emphasized patient self-care, used uniform clinical standards, and supported population-based data collection. This collaborative approach provided an effective way to achieve improved outcomes across a geographically and structurally diverse system, and it can help influence improvement efforts in other small and medium-sized rural communities.