Greater Southern California Node of the Clinical Trials Network

Project Summary/Abstract This application, responding to the Notice of Special Interest (NOSI) regarding the Availabilityof Administrative Supplements and Urgent Competitive Revisions for Research on the 2019 NovelCoronavirus (NOT-DA-20-047), requests an administrative supplement to the Rural Expansion ofMedication Treatment for Opioid Use Disorder (Rural MOUD, CTN-0102). The main purpose of theparent project is to investigate the impact of telemedicine (TM) on MOUD access and retention forindividuals with OUD in rural primary care settings. The coronavirus disease 2019 (COVID-19, orCOVID for short) pandemic has forced many health care systems to rapidly implement remote caremodels, which is of direct relevance to this project. Building upon the existing research plan, werequest an administrative supplement to conduct a thorough investigation of COVID's impact on TMpractices and access to MOUD in rural communities. In addition to characterizing changes inattitudes and perceptions regarding TM for OUD treatment, we will investigate and assess the impactof COVID over the next 2 years with regard to changes in MOUD access and services (especially TM)in rural primary care settings and in OUD patients' use of substances (particularly opioids) and healthconditions. Study specific aims include: Aim 1. To assess changes in MOUD access and services(especially TM) in rural primary care settings over the COVID pandemic, and Aim 2. To assesschanges in OUD patients' substance use (particularly opioids) and health conditions over the COVIDpandemic. The supplement funding will support (1) qualitative data collection and analysis thatincludes focus groups and semi-structured interviews to document COVID impact from theperspective of community stakeholders, providers, and patients drawn from primary care clinicsserving rural communities, and (2) quantitative data collection and analysis that includes healthrecords for patients served by the rural primary care clinics as well as self-report from OUD patients'participant surveys to investigate COVID impact on the use of healthcare, TM, and substances.Findings will contribute to scientific knowledge regarding COVID impact, responses, andconsequences in rural communities, as well as to inform and shape future development of remotecare models.