Associate Professor of Medicine Yale School of Medicine, Connecticut
Background & Introduction: In 2022, 29.5 million (10.5%) people aged 12 or older had a past year alcohol use disorder (AUD) in the United States. Left untreated, AUD can have severe medical consequences including alcohol-associated liver disease, cancer, and an increased risk for injuries. AUD also leads to pre-mature death and lower overall life expectancy for the United States compared to other developed countries.
Only 7.6% of those with AUD received treatment in the past year and only 2% took a Food and Drug Administration (FDA)-approved medication for AUD (MAUD). Despite FDA approval of highly effective, evidence-based MAUD, these medications are substantially underutilized. This treatment gap is partially because customized resources and training are not available for the various members of the workforce treating patients with AUD. The lack of education available leads to reduced healthcare professional confidence to provide effective AUD treatment, furthering poor outcomes for patients who receive inadequate care.
To address this treatment gap, Providers Clinical Support System–Medications for Alcohol Use Disorder (PCSS-MAUD) provides free, comprehensive training, guidance, and mentoring on the prevention, diagnosis, and treatment of AUD. PCSS-MAUD aims to enhance the capacity of multidisciplinary healthcare professionals to treat individuals with AUD, including with the use of FDA-approved MAUD.
Methods: PCSS-MAUD developed 6 online modules, 10 mini videos, 10 toolkits/infographics, 12 webinars, 8 case-based discussions, and 3 in-person trainings, within the first year of the program. PCSS-MAUD’s goal was to reach 2,000 learners within one year. Training topics and content were determined by the Clinical Advisory Program Committee, an interprofessional group of experts who work in diverse healthcare settings. Educational activities were developed after completing a needs assessment, literature review, and subject matter survey. All content was peer-reviewed by experts in AUD and the Clinical Advisory Program Committee for quality, accuracy, timeliness, consistency, and bias.
PCSS-MAUD collected learner data through post-educational activity evaluations that were analyzed by an external Program Evaluator. Evaluations consist of 16 questions that included Likert scale, multiple choice, and open-ended questions. Evaluations assessed for knowledge/skills-gained, intent to apply information, and demographics of respondents. Data was used for quality improvement of future educational activities and to assess the goals program of increasing the capacity of healthcare professionals to treat AUD.
Results: Within 9 months, PCSS-MAUD engaged 5,812 learners within live and recorded webinars and case-based discussions, as well as online modules. Furthermore, PCSS-MAUD mini videos and digital resources received a total of 2,457 views and downloads in Year 1.
Preliminary data indicates that physicians (MD/DO) were the primary audience among evaluation respondents (21.9%), followed by nurse practitioners (ARNP) (21.7%). This suggests that the primary audience for PCSS-MAUD is prescribers who can prescribe MAUD for patients with AUD.
Over 96% of evaluation respondents reported being “very satisfied” or “satisfied” with the quality of PCSS-MAUD events and “strongly agreed” or “agreed” that the event would benefit them or their community. Additionally, over 92% of learners “strongly agreed” or “agreed” that the event would improve their ability to work effectively, and 98% stated that they would recommend an educational activity to a colleague. These high ratings indicate that PCSS-MAUD educational activities resonated with its audience and that they are likely to apply what they learned about to their clinical practice.
Conclusion & Discussion: Providers Clinical Support System – Medications for Alcohol Use Disorder (PCSS-MAUD) aims to increase the capacity of healthcare professionals to identify, prevent, and treat alcohol use disorder by training 2,000 healthcare professionals within the first year of the program. PCSS-MAUD trained nearly three times its goal, with prescribers representing the primary learners. Furthermore, evaluation respondents report high rates of satisfaction and likelihood of applying learnings to practice. These results suggest both an immense need for clinician education on alcohol use disorder and the desire of prescribers to learn about and apply evidence-based treatments such as medications for alcohol use disorder to clinical practice. PCSS-MAUD may aid in closing the treatment gap by equipping healthcare professionals with the knowledge, skills, and confidence needed to treat alcohol use disorder.
References: 1. Substance Abuse and Mental Health Services Administration. (2023). Key substance use and mental health indicators in the United States: Results from the 2022 National Survey on Drug Use and Health (HHS Publication No. PEP23-07-01-006, NSDUH Series H-58). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
2. Edwards, S., Ferguson, T.F., Gasparini, S. et al. Interprofessional education as a potential foundation for future team-based prevention of alcohol use disorder. BMC Med Educ 23, 126 (2023). https://doi.org/10.1186/s12909-023-04100-y
3. Anderson P. (2009). Overview of interventions to enhance primary-care provider management of patients with substance-use disorders. Drug and alcohol review, 28(5), 567–574. https://doi.org/10.1111/j.1465-3362.2009.00113.x
4. Williams, E. C., Achtmeyer, C. E., Young, J. P., Berger, D., Curran, G., Bradley, K. A., Richards, J., Siegel, M. B., Ludman, E. J., Lapham, G. T., Forehand, M., & Harris, A. H. S. (2018). Barriers to and Facilitators of Alcohol Use Disorder Pharmacotherapy in Primary Care: A Qualitative Study in Five VA Clinics. Journal of general internal medicine, 33(3), 258–267. https://doi.org/10.1007/s11606-017-4202-z
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Learning Objectives:
Upon completion, participant will be able to identify at least two contributing factors to the underprescribing of medications for alcohol use disorder.
Upon completion, participant will be able to identify at least two educational strategies that PCSS-MAUD is implementing to address gaps in the treatment of alcohol use disorder.
Upon completion, participant will be able to describe at least one outcome for clinicians after participating in PCSS-MAUD alcohol use disorder education.
