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Published Online: 16 June 2022

Sex Differences in Comorbid Mental and Substance Use Disorders Among Primary Care Patients With Opioid Use Disorder

Jordan M. Braciszewski, Ph.D. [email protected], Abisola E. Idu, M.P.H., M.S., Bobbi Jo H. Yarborough, Psy.D., Scott P. Stumbo, M.A., Jennifer F. Bobb, Ph.D., Katharine A. Bradley, M.D., M.P.H., Rebecca C. Rossom, M.D., M.S., … Show All … , Mark T. Murphy, M.D., Ingrid A. Binswanger, M.D., M.P.H., Cynthia I. Campbell, Ph.D., M.P.H., Joseph E. Glass, Ph.D., M.S.W., Theresa E. Matson, M.P.H., Gwen T. Lapham, Ph.D., M.P.H., Amy M. Loree, Ph.D., Celestina Barbosa-Leiker, Ph.D., Mary A. Hatch, Ph.D., Judith I. Tsui, M.D., M.P.H., Julia H. Arnsten, M.D., M.P.H., Angela Stotts, Ph.D., Viviana Horigian, M.D., M.H.A., Rebecca Hutcheson, M.S.W., Gavin Bart, M.D., Ph.D., Andrew J. Saxon, M.D., Manu Thakral, Ph.D., R.N., Deborah Ling Grant, Ph.D., M.B.A., Chaya Mangel Pflugeisen, M.S., M.Ed., Ingrid Usaga, M.S.W., Lawrence T. Madziwa, M.S., Angela Silva, D.B.A., M.A.O.L., and Denise M. Boudreau, Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 73, Number 12
https://doi.org/10.1176/appi.ps.202100665
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Abstract

Objective:

The authors sought to characterize the 3-year prevalence of mental disorders and nonnicotine substance use disorders among male and female primary care patients with documented opioid use disorder across large U.S. health systems.

Methods:

This retrospective study used 2014–2016 data from patients ages ≥16 years in six health systems. Diagnoses were obtained from electronic health records or claims data; opioid use disorder treatment with buprenorphine or injectable extended-release naltrexone was determined through prescription and procedure data. Adjusted prevalence of comorbid conditions among patients with opioid use disorder (with or without treatment), stratified by sex, was estimated by fitting logistic regression models for each condition and applying marginal standardization.

Results:

Females (53.2%, N=7,431) and males (46.8%, N=6,548) had a similar prevalence of opioid use disorder. Comorbid mental disorders among those with opioid use disorder were more prevalent among females (86.4% vs. 74.3%, respectively), whereas comorbid other substance use disorders (excluding nicotine) were more common among males (51.9% vs. 60.9%, respectively). These differences held for those receiving medication treatment for opioid use disorder, with mental disorders being more common among treated females (83% vs. 71%) and other substance use disorders more common among treated males (68% vs. 63%). Among patients with a single mental health condition comorbid with opioid use disorder, females were less likely than males to receive medication treatment for opioid use disorder (15% vs. 20%, respectively).

Conclusions:

The high rate of comorbid conditions among patients with opioid use disorder indicates a strong need to supply primary care providers with adequate resources for integrated opioid use disorder treatment.

HIGHLIGHTS

•
Approximately nine in 10 females and eight in 10 males with an opioid use disorder also had a comorbid mental health condition or other nonnicotine substance use disorder.
•
Among patients with an opioid use disorder (with or without medication treatment), comorbid mental conditions were more common among females, whereas other nonnicotine substance use disorders were more prevalent among males.
•
Females with a single comorbid mental health condition (i.e., no other nonopioid or nonnicotine substance use disorders) were less likely to receive medication treatment for opioid use disorder compared with males.
The United States continues to face an opioid crisis; from 2000 to 2014, the prevalence of opioid use disorders increased 125%, and opioid-related overdose deaths increased 200% (1, 2), even when levels of prescribing did not increase (3). Treatment for opioid use disorder in general medical settings may be more convenient and less stigmatizing for patients than in settings for specialized treatment for substance use and allows for interventions in the context of other health needs (4). At the same time, the burden on primary care continues to expand, straining resources (5). As primary care–based opioid use disorder treatment proliferates, understanding the landscape of disorder complexity among patients is important, as is identifying effective means of triage and resource allocation, including what is needed to successfully and comprehensively treat patients with opioid use disorder (6).
Mental disorders and other substance use disorders are common among patients with opioid use disorder (7–10) and may require protocols and clinical pathways that differ from standard treatment. Diagnoses of comorbid mental and substance use disorders are also associated with higher risk for relapse, nonadherence to medication treatment for opioid use disorder (11, 12), and lower likelihood of completing treatment (13). Current estimates of these diagnoses among individuals with opioid use disorder range widely, however—from 25% to 90% for mental disorders (7, 8, 10, 14–17) and from 16% to 75% (7–9, 14, 15) for nonnicotine substance use disorders. Nearly all of these estimates come from studies of patients seeking opioid use disorder treatment and may not provide an accurate picture of primary care populations. Given the potential impact of these diagnoses on opioid use disorder treatment protocols, resource allocation, and patient outcomes, it is important to estimate their prevalence in the general population.
It is essential, however, to consider sex when examining the prevalence of mental health and substance use comorbidity among patients with opioid use disorder (18). Findings from national data of individuals with opioid use disorder indicate that females are twice as likely as males to have a mood or an anxiety disorder (19). Results of a pretreatment assessment of individuals with opioid use disorder indicated that females were more likely to test positive for amphetamines, methamphetamine, and phencyclidine, whereas males more commonly tested positive for alcohol, methadone, and cannabis use (20). In studies of opioid use disorder (21, 22) or general substance use disorders (20, 23), females reported current and past psychiatric problems more often than did males. Finally, females have reported greater functional impairment due to a substance use disorder or psychiatric symptoms (20, 23, 24).
A better understanding of sex-stratified rates of comorbid mental and substance use disorder diagnoses among patients with opioid use disorder (treated or untreated) is essential to further treatment efforts (18, 25). Our aim was to describe the 3-year prevalence of mental and nonnicotine substance use disorder diagnoses among male and female primary care patients with documented opioid use disorder—with and without medication treatment for opioid use disorder—across six diverse U.S. health systems.

Methods

Settings

Six health systems contributed data for this retrospective cross-sectional study, including data from four Kaiser Permanente (KP) regional health systems (Washington State, Northwest [Oregon], Northern California, and Colorado), HealthPartners (Minnesota and Wisconsin), and MultiCare Health System (Washington State). The KP health systems and HealthPartners both insure and provide comprehensive care to their enrollees and receive claims from care delivered in external facilities. Three of the KP health systems (Northwest, Northern California, and Colorado) are integrated care systems, HealthPartners and KP Washington are mixed-model systems (integrated delivery system and contracted network providers and clinics), and MultiCare is a fee-for-service community health care system serving primarily urban and some rural populations. All six health systems use the Epic electronic health record (EHR) system. All except MultiCare are part of the Health Care Systems Research Network and thus have organized their EHR and claims data in a common data model (26); MultiCare data were translated to this format for analyses. The study was approved and monitored by the KP Washington Institutional Review Board.

Sample

The sample was identified from existing EHR and claims data in phase 1 of the Primary Care Opioid Use Disorders (PROUD) study, a National Institute on Drug Abuse–Clinical Trials Network–sponsored pragmatic, cluster-randomized controlled trial (protocol CTN-0074) of the efficacy of collaborative care for increasing access to and maintenance of medication for opioid use disorder in primary care (27). Phase 1 was a prerandomization pilot study to assess the feasibility of the health systems and their data for the trial (28, 29) and reflected sites different from those in the actual trial (27). This study sample included patients ages ≥16 years who made at least two primary care visits to the same participating health system between October 1, 2013, and September 30, 2016 (fiscal year [FY] 2014–2016). Two or more visits were required for inclusion to reduce the likelihood of including patients who were not regularly receiving care in the clinics. Four health systems included patients seen in all of their primary care clinics, one health system included patients seen in five large primary care clinics (≥20,000 patients per clinic), and another included patients seen in primary care clinics that were not close to or colocated with substance use disorder treatment services (five to 25 primary care clinics were included per health system).

Data Source and Measures

Data elements from EHR and claims data over the 3-year study period included patient demographic characteristics, diagnoses, and procedures, as well as pharmacy dispensings (five sites) or medication orders (one site), which are referred to as prescriptions hereafter. Demographic characteristics at the time of study entry (e.g., initial visit to a study clinic during the study period) included age, binary sex as recorded in the EHR (representing legal sex or sex assigned at birth), race-ethnicity, and health insurance type (which was missing for one site).
Visit-based diagnoses were based on ICD-9-CM (until September 30, 2015) or ICD-10-CM diagnostic codes (starting October 1, 2015). Mental disorders of interest included anxiety, depression, serious psychiatric illnesses (bipolar disorder and schizophrenia and other psychosis), attention-deficit hyperactivity disorder (ADHD), and eating disorders. Substance use disorders included use of alcohol, cannabis, stimulants, and other drugs. Nicotine use disorder was assessed separately. Patients were classified as having a documented opioid use disorder if they had an ICD code for opioid use disorder—including remission. Remission codes were included because diagnostic codes are applied inconsistently and accuracy of active and remission status in primary samples is unknown and because we were interested in characterizing comorbid conditions irrespective of active or remission status. A Charlson Comorbidity Index (CCI) score (30) was created by using diagnostic codes during the first FY of study entry. Diagnoses were derived from encounters occurring anywhere in the health system. The CCI score is a sum of 17 comorbid conditions that are weighted according to the relative risk for 1-year mortality (30, 31). A higher CCI score indicates increased disease burden and risk of death.
Opioid use disorder treatment was defined as any documented prescription of buprenorphine formulations (transmucosal, implant, or extended-release [XR] injection), with or without naloxone, indicated for treatment of opioid use disorder, at any time during the 3-year study period throughout the health system. As a secondary treatment outcome, XR naltrexone use for opioid use disorder was determined from at least one procedure code or an XR naltrexone prescription plus an opioid use disorder diagnosis. Oral naltrexone was not included as opioid use disorder treatment because most oral naltrexone use is for alcohol use disorder (32, 33). Opioid use disorder treatment was restricted to these formulations because none of the health systems had internal federally approved methadone treatment programs.

Data Analytic Strategy

We used descriptive statistics to characterize the sample overall and by sex. The prevalence of mental and substance use disorder diagnoses was estimated among females and males with opioid use disorder by fitting separate logistic regression models for aggregates (e.g., any mental or substance use disorder diagnosis), as well as each mental and substance use disorder diagnosis, and then applying marginal standardization (34). Regression models included age in FY 2014 (modeled as a categorical variable), race-ethnicity, and health system. From the fitted models, we obtained marginal predictions (and 95% confidence intervals [CIs]) for females and males to describe the adjusted prevalence of diagnoses (35). The same approach was used to estimate the adjusted prevalence of mental and substance use disorder diagnoses (both as comorbid and individual disorders) for the subset of females and males with documented opioid use disorder who also received opioid use disorder medication treatment.
Finally, to assess whether comorbid diagnoses were associated with receipt of opioid use disorder treatment, we described the adjusted prevalence of opioid use disorder medication treatment across four mutually exclusive comorbidity groups on the basis of the presence of one or more mental or substance use disorder diagnoses. The four groups were the following: no mental or substance use disorder diagnosis, substance use disorder diagnoses only, mental disorder diagnoses only, and both mental and substance use disorder diagnoses. Prevalence of treatment (any opioid use disorder treatment, buprenorphine, or injectable XR naltrexone) was estimated in logistic regression models similar to those described above and that included an interaction term for sex and comorbidity group.

Results

Overall, 1% (N=13,979) of the individuals in the total PROUD phase 1 sample (N=1,403,266) were classified as having an opioid use disorder, with similar prevalence among females (N=7,431, 53.2%) and males (N=6,548, 46.8%) (Table 1). Nearly 93% of opioid use disorder diagnoses captured in the study time frame were classified as active. The mean±SD age was 45.4±17.0 years (range 16–98) and 42.4±16.2 years (range 16–99) among females and males, respectively. Most patients with an opioid use disorder were White (78.6%), followed by Black (6.6%) and multiracial (3.3%), and 6.2% indicated Hispanic ethnicity. More than half of the patients were commercially insured, and nearly one-quarter (22.5%) received Medicare. Approximately 6% had a CCI score ≥2, and close to two-thirds (60.4%) had a nicotine use disorder.
TABLE 1. Characteristics of primary care patients with opioid use disorder in six U.S. health care systems, fiscal years 2014–2016
CharacteristicFemales (N=7,431)Males (N=6,548)Total (N=13,979)
N%N%N%
Age in years      
 16–171091.5841.31931.4
 18–2596313.01,16417.82,12715.2
 26–351,41319.01,44422.12,85720.4
 36–451,30017.51,02915.72,32916.7
 46–551,52220.51,19018.22,71219.4
 56–651,21616.41,11917.12,33516.7
 66–755437.33835.89266.6
 >753654.91352.15003.6
Race-ethnicity      
 Hispanic4335.84296.68626.2
 Non-Hispanic      
  White5,90479.55,07777.510,98178.6
  Black4906.64346.69246.6
  Asian721.01041.61761.3
  Native American or Alaska Native901.2600.91501.1
  Hawaiian or Pacific Islander15.226.441.3
  Multiracial2723.71963.04683.3
  Other49.749.798.7
  Unknown1061.41732.62792.0
Insurance typea      
 Medicare1,41225.495719.32,36922.5
 Commercial2,95953.23,20364.66,16258.6
 Medicaid1,04718.863512.81,68216.0
 Uninsured1422.61603.23022.9
Charlson Comorbidity Index score ≥2b4305.84617.08916.4
Hepatitis C virus5437.369210.61,2358.8
HIV or AIDS24.31081.6132.9
Active opioid use disorderc6,90292.96,05292.412,95492.7
Opioid use disorder in remissionc1,82324.51,82927.93,65226.1
Opioid use disorder treatmentd1,31217.71,56123.82,87320.6
 Buprenorphine1,28317.31,52223.22,80520.1
 Injectable extended-release naltrexone61.8731.11341.0
Nicotine use disorder4,37758.94,06162.08,43860.4
a
Excludes HealthPartners because insurance status was unavailable (N=1,871 females and 1,593 males).
b
The score is a sum of 17 comorbid conditions weighted according to the relative risk for 1-year mortality; a higher score indicates increased disease burden and risk of death.
c
Not mutually exclusive categories because a patient may have received diagnoses of both active opioid use disorder and opioid use disorder in remission during the study period.
d
Defined as one or more prescription or procedure codes for buprenorphine formulations used to manage opioid use disorder (transmucosal, implants, or sustained injection) or injectable extended-release naltrexone throughout the health system.

Prevalence of Mental and Substance Use Disorder Diagnoses Among Females and Males With Opioid Use Disorder

Compared with males with opioid use disorder, females with opioid use disorder had higher rates of mental disorders, both overall (86.4% females and 74.3% males) and among four of the five distinct categories we examined (Table 2). Prevalence of ADHD (10.4% females and 11.5% males) was similar for the two groups. Compared with females, males had higher prevalence of other nonnicotine substance use disorders overall (51.9% females vs. 60.9% males) and for each disorder that involved alcohol, cannabis, stimulants, and other substances (Table 2). More females than males had a substance use disorder or psychiatric diagnosis (90.8% females and 85.9% males), but females and males had similar prevalence of having both a substance use disorder and mental disorder (47.5% females and 49.2% males).
TABLE 2. Mental and other nonnicotine substance use disorder diagnoses among primary care patients with an opioid use disorder diagnosis during fiscal years 2014–2016 (N=13,979)a
DiagnosisFemales (N=7,431)Males (N=6,548)
%b95% CI%b95% CI
Any psychiatric86.485.7–87.274.373.2–75.4
 Depression70.869.8–71.857.256.1–58.4
 Anxiety70.769.7–71.755.954.8–57.1
 Serious mental illnessc19.918.9–20.816.015.1–16.9
 ADHD10.49.7–11.111.510.8–12.3
 Eating disorder3.83.3–4.2.5.4–.7
Any other nonnicotine substance use disorder51.950.8–53.060.959.7–62.0
 Alcohol24.723.7–25.733.532.4–34.6
 Cannabis13.913.1–14.720.920.0–21.8
 Stimulants17.116.3–18.020.019.1–20.9
 Other drugs34.833.7–35.837.436.3–38.6
Any mental or other substance use disorder90.890.1–91.585.985.0–86.7
 Both mental and other substance use disorder47.546.4–48.649.248.1–50.4
 Other substance use disorder only4.33.8–4.811.510.7–12.2
 Psychiatric only38.837.7–39.924.923.9–25.9
No mental or other substance use disorder9.28.6–9.914.113.3–15.0
a
ADHD, attention-deficit hyperactivity disorder.
b
Prevalence estimates (and 95% confidence intervals)—adjusted for health system, age, and race-ethnicity—were obtained by fitting a logistic regression model and then applying marginal standardization.
c
Any serious mental illness defined as bipolar disorder, schizophrenia, or other psychosis.

Prevalence of Mental and Substance Use Disorders Among Females and Males Receiving Medication Treatment for Opioid Use Disorder

The prevalence of any mental disorders was 71% among males treated with medications for opioid use disorder and 83% among treated females (Table 3); prevalence of other nonnicotine substance use disorders was 68% and 63% among treated males and females, respectively. Females who received treatment were slightly more likely than males who received treatment to have a diagnosis of any comorbid mental or substance use disorder (90% vs. 86%). Only a small proportion of treated females (10%) and males (14%) had no mental or other substance use disorder diagnosis.
TABLE 3. Prevalence of mental and other substance use disorder diagnoses among primary care patients with medication treatment of opioid use disordera during fiscal years 2014–2016 (N=2,873)
DiagnosisFemales (N=1,312)Males (N=1,561)
%b95% CI%b95% CI
Any psychiatric8380–857169–73
Any other substance use disorder6360–656865–70
Any mental or other substance use disorder9088–918684–88
 Both mental and other substance use disorder5553–585250–55
 Other substance use disorder only86–91614–17
 Psychiatric only2725–301917–21
No mental or other substance use disorder109–121412–16
a
Defined as one or more prescriptions or procedure codes for buprenorphine formulations used to manage opioid use disorder (transmucosal, implants, or sustained injection) or injectable extended-release naltrexone throughout the health system.
b
Prevalence estimates (and 95% confidence intervals)—adjusted for health system, age, and race-ethnicity—were obtained by fitting a logistic regression model and then applying marginal standardization.

Prevalence of Opioid Use Disorder Treatment in Four Diagnosis Subgroups

No meaningful differences in medication treatment for opioid use disorder were detected across the various mental and substance use disorder subgroups (see Table S1 in an online supplement to this article). However, females with opioid use disorder but no other substance use disorder and who had additional mental health conditions (15%, 95% CI=14%–16%) were less likely than males to receive opioid use disorder treatment (20%, 95% CI=18%–22%).

Discussion

In this large multisite observational study, diagnoses of mental and nonnicotine substance use disorders were common among both female and male primary care patients with a documented opioid use disorder. Females with opioid use disorder had a higher prevalence of mental health conditions than males, and males with opioid use disorder had a higher prevalence of other substance use disorders than females. This sex-stratified pattern was also present among patients receiving medication treatment for opioid use disorder. Very few individuals receiving such medications were without a diagnosis of a comorbid mental or substance use disorder. Females in our sample with comorbid mental disorder only were less likely to receive medication treatment for opioid use disorder than were males with comorbid mental disorder only.
According to data from EHRs (16, 17), intake interviews (10), and chart reviews (7), rates of comorbid mental and opioid use disorders range from 66% to 79%, similar to the range in our sample (71%–83%). Rates of comorbid nonnicotine substance use disorders with opioid use disorder range from 16% to 75% (7–9, 14, 15), with higher rates among patients receiving office-based medication treatment and lower rates among individuals in mental health (15) or chronic pain treatment (9). The prevalence of nonnicotine substance use disorder comorbid with opioid use disorder was lower when a structured clinical interview, rather than health record data, was used (9, 14). We note that our estimates are based on a 3-year period, and opioid use disorder treatment was not restricted to primary care, whereas samples described in the literature consist almost exclusively of individuals seeking opioid use disorder treatment (vs. the general primary care population). Regardless, our estimates suggest that significant resources are needed for treating individuals with opioid use disorder in primary care. Collaborative care models may be useful, given the spread of responsibility across multiple providers and previous successes in primary care (36). Recent expansion of telemedicine services due to the COVID-19 pandemic (37) may improve primary care capacity to treat this population.
Consistent with studies reporting differences in mental health conditions and substance use disorder among sexes (38), females with opioid use disorder were more likely than males to have comorbid psychiatric diagnoses, whereas males with opioid use disorder were more likely to have comorbid substance use disorders (both for individuals with or without treatment for opioid use disorder). It is possible that the clinical setting in which individuals presented may have played a role in these sex differences. Females are more likely to present in primary care (39, 40), where providers may be more comfortable addressing mental disorders (41) rather than substance use disorders (42, 43). It was beyond the scope of this study to determine where diagnoses were originally documented, precluding conjecture about these sex-specific patterns aside from their similarity to general population trends.
Males and females appeared similarly likely to receive medication treatment for opioid use disorder regardless of a diagnosis of a comorbid mental or substance use disorder, a finding that conflicts with results from research indicating that females are less likely to receive substance use disorder treatment of all types (38). Females who had an additional diagnosis of a comorbid mental disorder only were the sole subgroup to be less likely to receive medication treatment for opioid use disorder. Given that females are more likely to visit primary care (39, 40), it is possible that, without primary care–based opioid use disorder treatment, this subgroup may have experienced service disparities. In contrast, females with an additional substance use disorder may seek specialty care that subsequently identifies and manages their opioid use disorder with medications. As noted, our study could not assess where diagnoses were made within the health system or via contact in the community or whether patients received mental health treatment. In general, however, levels of medication treatment for opioid use disorder were low, consistent with previous studies (44–47) and likely a result of numerous barriers to care (48, 49).
We note several limitations of this study. The use of EHRs and claims as the data source, rather than standardized assessments, had the potential for diagnosis misclassification. Misclassification can occur in either direction (e.g., a missed diagnosis because of underdiagnosis or undercoding or overdiagnosis because of incorrect coding of, for example, physical dependence on prescribed opioids coded as opioid use disorder). Moreover, some patients may have been using buprenorphine for symptom management during an opioid taper rather than for opioid use disorder treatment. External medication orders were not captured in the EHRs (which was relevant to one study site with such orders), and medications dispensed from pharmacies not owned by the health plan were not captured if no insurance claim was submitted (e.g., self-pay, which was relevant to five sites with dispensings). In general, however, capture of health care utilization was almost complete at the five sites that received claims for outside services, and the community health system site reported providing comprehensive care to most of its patients.
Our treatment estimates were focused on opioid use disorder treatments that can be provided in primary care; therefore, data from methadone maintenance treatment were absent in our analysis, likely underestimating the true prevalence of treatment for opioid use disorder in our sample. We did not have data on the number of patients offered medications to manage opioid use disorder. Prevalence of posttraumatic stress disorder among our population was very low (0.3%; data not shown), which may reflect some underdiagnosis of this disorder. Identification of trauma exposure is important for accurate analysis (50), given both sex differences in trauma diagnoses (51) and impact of trauma on treatment outcomes (52). Our data were solely descriptive and did not offer explanations for the observed differences in prevalence of disease and treatment, and we cannot make conclusions about whether any comorbid conditions preceded or followed opioid use disorder. Our sample was predominantly White and therefore may not be generalizable to patients of other races or ethnicities who may be more or less likely to receive care in other settings (53, 54). Finally, the generalizability of our findings may have been limited by the fact that the sample included only patients regularly interacting with the health care systems whose data were used in this study.

Conclusions

This study provides robust, generalizable information about the 3-year prevalence of comorbid mental disorders and nonnicotine substance use disorders among male and female primary care patients with opioid use disorder, including those who received medication treatment for this disorder, in six large health care systems. The sample was large, had high geographic diversity, and represented both rural and urban communities. Health care systems should collect data on gender separately from data on sex assigned at birth, which would allow future studies to examine comorbid conditions and potential vulnerabilities among individuals of different gender identities, given reports of disproportionate substance use among gender minority groups. Future research should also address the reduced likelihood of medication treatment for opioid use disorder among females without other substance use disorders but with comorbid mental health conditions. Overall, the prevalence of comorbid conditions in the population studied suggests that primary care–based opioid use disorder treatment may need significant resources to adequately care for such patients. Continued integration of mental health services and substance use disorder services into primary care may decrease stigma and increase providers’ ability to address the complex needs of patients with opioid use disorder.

Supplementary Material

File (appi.ps.202100665.ds001.pdf)

References

1.
Saha TD, Kerridge BT, Goldstein RB, et al: Nonmedical prescription opioid use and DSM-5 nonmedical prescription opioid use disorder in the United States. J Clin Psychiatry 2016; 77:772–780
Crossref
PubMed
Google Scholar
2.
Rudd RA, Aleshire N, Zibbell JE, et al: Increases in drug and opioid overdose deaths—United States, 2000–2014. Am J Transplant 2016; 16:1323–1327
Crossref
Google Scholar
3.
Guy GP, Zhang K, Bohm MK, et al: Vital signs: changes in opioid prescribing in the United States, 2006–2015. Morb Mortal Wkly Rep 2017; 66:697–704
Crossref
PubMed
Google Scholar
4.
Chou R, Korthuis P, Weimer M, et al: Medication-Assisted Treatment Models of Care for Opioid Use Disorder in Primary Care Settings. Rockville, MD, Agency for Healthcare Research and Quality, 2016
Google Scholar
5.
Yarnall KS, Pollak KI, Østbye T, et al: Primary care: is there enough time for prevention? Am J Public Health 2003; 93:635–641
Crossref
PubMed
Google Scholar
6.
Snell-Rood C, Pollini RA, Willging C: Barriers to integrated medication-assisted treatment for rural patients with co-occurring disorders: the gap in managing addiction. Psychiatr Serv 2021; 72:935–942
Crossref
PubMed
Google Scholar
7.
Logan DE, Lavoie AM, Zwick WR, et al: Integrating addiction medicine into rural primary care: strategies and initial outcomes. J Consult Clin Psychol 2019; 87:952–961
Crossref
PubMed
Google Scholar
8.
Neumann AM, Blondell RD, Azadfard M, et al: Primary care patient characteristics associated with completion of 6-month buprenorphine treatment. Addict Behav 2013; 38:2724–2728
Crossref
PubMed
Google Scholar
9.
Barry DT, Cutter CJ, Beitel M, et al: Psychiatric disorders among patients seeking treatment for co-occurring chronic pain and opioid use disorder. J Clin Psychiatry 2016; 77:1413–1419
Crossref
PubMed
Google Scholar
10.
Simon CB, Tsui JI, Merrill JO, et al: Linking patients with buprenorphine treatment in primary care: predictors of engagement. Drug Alcohol Depend 2017; 181:58–62
Crossref
PubMed
Google Scholar
11.
Fareed A, Eilender P, Ketchen B, et al: Factors affecting noncompliance with buprenorphine maintenance treatment. J Addict Med 2014; 8:345–350
Crossref
PubMed
Google Scholar
12.
Litz M, Leslie D: The impact of mental health comorbidities on adherence to buprenorphine: a claims based analysis. Am J Addict 2017; 26:859–863
Crossref
PubMed
Google Scholar
13.
Krawczyk N, Feder KA, Saloner B, et al: The association of psychiatric comorbidity with treatment completion among clients admitted to substance use treatment programs in a US national sample. Drug Alcohol Depend 2017; 175:157–163
Crossref
PubMed
Google Scholar
14.
Savant JD, Barry DT, Cutter CJ, et al: Prevalence of mood and substance use disorders among patients seeking primary care office-based buprenorphine/naloxone treatment. Drug Alcohol Depend 2013; 127:243–247
Crossref
PubMed
Google Scholar
15.
Presnall NJ, Wolf DAPS, Brown DS, et al: A comparison of buprenorphine and psychosocial treatment outcomes in psychosocial and medical settings. J Subst Abuse Treat 2019; 104:135–143
Crossref
PubMed
Google Scholar
16.
Weinstein ZM, Kim HW, Cheng DM, et al: Long-term retention in office based opioid treatment with buprenorphine. J Subst Abuse Treat 2017; 74:65–70
Crossref
PubMed
Google Scholar
17.
Cantone RE, Garvey B, O’Neill A, et al: Predictors of medication-assisted treatment initiation for opioid use disorder in an interdisciplinary primary care model. J Am Board Fam Med 2019; 32:724–731
Crossref
PubMed
Google Scholar
18.
Barbosa-Leiker C, Campbell AN, McHugh RK, et al: Opioid use disorder in women and the implications for treatment. Psychiatr Res Clin Pract 2021; 3:3–11
Crossref
PubMed
Google Scholar
19.
Grella CE, Karno MP, Warda US, et al: Gender and comorbidity among individuals with opioid use disorders in the NESARC study. Addict Behav 2009; 34:498–504
Crossref
PubMed
Google Scholar
20.
Back SE, Payne RL, Wahlquist AH, et al: Comparative profiles of men and women with opioid dependence: results from a national multisite effectiveness trial. Am J Drug Alcohol Abuse 2011; 37:313–323
Crossref
PubMed
Google Scholar
21.
Green TC, Grimes Serrano JM, Licari A, et al: Women who abuse prescription opioids: findings from the Addiction Severity Index–Multimedia Version Connect prescription opioid database. Drug Alcohol Depend 2009; 103:65–73
Crossref
PubMed
Google Scholar
22.
Ross J, Teesson M, Darke S, et al: The characteristics of heroin users entering treatment: findings from the Australian treatment outcome study (ATOS). Drug Alcohol Rev 2005; 24:411–418
Crossref
PubMed
Google Scholar
23.
Sordo L, Chahua M, Bravo M, et al: Depression among regular heroin users: the influence of gender. Addict Behav 2012; 37:148–152
Crossref
PubMed
Google Scholar
24.
Hernandez-Avila CA, Rounsaville BJ, Kranzler HR: Opioid-, cannabis- and alcohol-dependent women show more rapid progression to substance abuse treatment. Drug Alcohol Depend 2004; 74:265–272
Crossref
PubMed
Google Scholar
25.
McHugh RK: The importance of studying sex and gender differences in opioid misuse. JAMA Netw Open 2020; 3:e2030676
Crossref
PubMed
Google Scholar
26.
Ross TR, Ng D, Brown JS, et al: The HMO research network virtual data warehouse: a public data model to support collaboration. EGEMS 2014; 2:1049
Crossref
PubMed
Google Scholar
27.
Campbell CI, Saxon AJ, Boudreau DM, et al: PRimary Care Opioid Use Disorders treatment (PROUD) trial protocol: a pragmatic, cluster-randomized implementation trial in primary care for opioid use disorder treatment. Addict Sci Clin Pract 2021; 16:1–15
Crossref
PubMed
Google Scholar
28.
Lapham G, Boudreau DM, Johnson EA, et al: Prevalence and treatment of opioid use disorders among primary care patients in six health systems. Drug Alcohol Depend 2020; 207:107732
Crossref
PubMed
Google Scholar
29.
Boudreau DM, Lapham G, Johnson EA, et al: Documented opioid use disorder and its treatment in primary care patients across six US health systems. J Subst Abuse Treat 2020; 112:41–48
Crossref
Google Scholar
30.
Sundararajan V, Henderson T, Perry C, et al: New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality. J Clin Epidemiol 2004; 57:1288–1294
Crossref
PubMed
Google Scholar
31.
Deyo RA, Cherkin DC, Ciol MA: Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992; 45:613–619
Crossref
PubMed
Google Scholar
32.
Minozzi S, Amato L, Vecchi S, et al: Oral naltrexone maintenance treatment for opioid dependence. Cochrane Database Syst Rev 2011; 2011:CD001333
Google Scholar
33.
Barocas JA, White LF, Wang J, et al: Estimated prevalence of opioid use disorder in Massachusetts, 2011–2015: a capture–recapture analysis. Am J Public Health 2018; 108:1675–1681
Crossref
PubMed
Google Scholar
34.
Muller CJ, MacLehose RF: Estimating predicted probabilities from logistic regression: different methods correspond to different target populations. Int J Epidemiol 2014; 43:962–970
Crossref
PubMed
Google Scholar
35.
Basu A, Rathouz PJ: Estimating marginal and incremental effects on health outcomes using flexible link and variance function models. Biostatistics 2005; 6:93–109
Crossref
PubMed
Google Scholar
36.
Watkins KE, Ober AJ, Lamp K, et al: Collaborative care for opioid and alcohol use disorders in primary care: the SUMMIT randomized clinical trial. JAMA Intern Med 2017; 177:1480–1488
Crossref
PubMed
Google Scholar
37.
Wosik J, Fudim M, Cameron B, et al: Telehealth transformation: COVID-19 and the rise of virtual care. J Am Med Inform Assoc 2020; 27:957–962
Crossref
PubMed
Google Scholar
38.
2017 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, 2018
Google Scholar
39.
Wang Y, Hunt K, Nazareth I, et al: Do men consult less than women? An analysis of routinely collected UK general practice data. BMJ Open 2013; 3:e003320
Crossref
PubMed
Google Scholar
40.
Thompson AE, Anisimowicz Y, Miedema B, et al: The influence of gender and other patient characteristics on health care-seeking behaviour: a QUALICOPC study. BMC Fam Pract 2016; 17:38
Crossref
PubMed
Google Scholar
41.
Mental Health in Primary Care: Illusion or Inclusion? Geneva, World Health Organization, 2018
Google Scholar
42.
Chan Y-F, Lu S-E, Howe B, et al: Screening and follow-up monitoring for substance use in primary care: an exploration of rural–urban variations. J Gen Intern Med 2016; 31:215–222
Crossref
PubMed
Google Scholar
43.
Saunders EC, Moore SK, Gardner T, et al: Screening for substance use in rural primary care: a qualitative study of providers and patients. J Gen Intern Med 2019; 34:2824–2832
Crossref
PubMed
Google Scholar
44.
Donohue JM, Barry CL, Stuart EA, et al: Effects of global payment and accountable care on medication treatment for alcohol and opioid use disorders. J Addict Med 2018; 12:11–18
Crossref
PubMed
Google Scholar
45.
Wu L-T, Zhu H, Swartz MS: Treatment utilization among persons with opioid use disorder in the United States. Drug Alcohol Depend 2016; 169:117–127
Crossref
PubMed
Google Scholar
46.
Morgan JR, Schackman BR, Leff JA, et al: Injectable naltrexone, oral naltrexone, and buprenorphine utilization and discontinuation among individuals treated for opioid use disorder in a United States commercially insured population. J Subst Abuse Treat 2018; 85:90–96
Crossref
PubMed
Google Scholar
47.
Thomas CP, Ritter GA, Harris AHS, et al: Applying American Society of Addiction Medicine performance measures in commercial health insurance and services data. J Addict Med 2018; 12:287–294
Crossref
PubMed
Google Scholar
48.
Hutchinson E, Catlin M, Andrilla CHA, et al: Barriers to primary care physicians prescribing buprenorphine. Ann Fam Med 2014; 12:128–133
Crossref
PubMed
Google Scholar
49.
Sharma A, Kelly SM, Mitchell SG, et al: Update on barriers to pharmacotherapy for opioid use disorders. Curr Psychiatry Rep 2017; 19:35
Crossref
PubMed
Google Scholar
50.
Hooker SA, Sherman MD, Lonergan-Cullum M, et al: Mental health and psychosocial needs of patients being treated for opioid use disorder in a primary care residency clinic. J Prim Care Community Health 2020; 11:2150132720932017
Crossref
Google Scholar
51.
Kilpatrick DG, Resnick HS, Milanak ME, et al: National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. J Trauma Stress 2013; 26:537–547
Crossref
PubMed
Google Scholar
52.
Peirce JM, Brooner RK, King VL, et al: Effect of traumatic event reexposure and PTSD on substance use disorder treatment response. Drug Alcohol Depend 2016; 158:126–131
Crossref
PubMed
Google Scholar
53.
Andraka-Christou B: Addressing racial and ethnic disparities in the use of medications for opioid use disorder: study examines racial and ethnic disparities in the use of medications for opioid use disorder. Health Aff 2021; 40:920–927
Crossref
Google Scholar
54.
Goedel WC, Shapiro A, Cerdá M, et al: Association of racial/ethnic segregation with treatment capacity for opioid use disorder in counties in the United States. JAMA Netw Open 2020; 3:e203711
Crossref
PubMed
Google Scholar

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 73 • Number 12 • December 01, 2022
Pages: 1330 - 1337
PubMed: 35707859

History

Received: 21 November 2021
Revision received: 22 March 2022
Accepted: 31 March 2022
Published online: 16 June 2022
Published in print: December 01, 2022

Keywords

  1. Primary care
  2. Drug treatment
  3. Opioid-related disorder
  4. Substance use disorder
  5. Sex differences
  6. Mental health

Authors

Details

Jordan M. Braciszewski, Ph.D. [email protected]
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Abisola E. Idu, M.P.H., M.S.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Bobbi Jo H. Yarborough, Psy.D.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Scott P. Stumbo, M.A.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Jennifer F. Bobb, Ph.D.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Katharine A. Bradley, M.D., M.P.H.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Rebecca C. Rossom, M.D., M.S.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Mark T. Murphy, M.D.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
View all articles by this author
Ingrid A. Binswanger, M.D., M.P.H.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
View all articles by this author
Cynthia I. Campbell, Ph.D., M.P.H.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
View all articles by this author
Joseph E. Glass, Ph.D., M.S.W.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
View all articles by this author
Theresa E. Matson, M.P.H.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Gwen T. Lapham, Ph.D., M.P.H.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Amy M. Loree, Ph.D.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Celestina Barbosa-Leiker, Ph.D.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Mary A. Hatch, Ph.D.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Judith I. Tsui, M.D., M.P.H.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Julia H. Arnsten, M.D., M.P.H.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Angela Stotts, Ph.D.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Viviana Horigian, M.D., M.H.A.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Rebecca Hutcheson, M.S.W.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Gavin Bart, M.D., Ph.D.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Andrew J. Saxon, M.D.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Manu Thakral, Ph.D., R.N.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Deborah Ling Grant, Ph.D., M.B.A.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Chaya Mangel Pflugeisen, M.S., M.Ed.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Ingrid Usaga, M.S.W.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Lawrence T. Madziwa, M.S.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Angela Silva, D.B.A., M.A.O.L.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Denise M. Boudreau, Ph.D.
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit (Braciszewski, Loree); Kaiser Permanente Washington Health Research Institute (KPWHRI), Seattle (Idu, Bobb, Bradley, Glass, Matson, Lapham, Madziwa); Kaiser Permanente Northwest Center for Health Research, Portland, Oregon (Yarborough, Stumbo); HealthPartners Institute and Department of Research, University of Minnesota, Minneapolis (Rossom); MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington (Murphy, Pflugeisen, Silva); Kaiser Permanente Colorado Institute for Health Research, Colorado Permanente Medical Group, Department of Health System Science, Bernard J. Tyson Kaiser Permanente School of Medicine, University of Colorado School of Medicine, Aurora (Binswanger); Kaiser Permanente Northern California Division of Research, Oakland (Campbell); Department of Health Systems and Population Health, University of Washington, Seattle (Lapham, Hutcheson); Washington State University Health Sciences Spokane, Spokane (Barbosa-Leiker); Department of Psychiatry and Behavioral Sciences and Addictions, Drug and Alcohol Institute, University of Washington, Seattle (Hatch); Department of Medicine, University of Washington and Harborview Medical Center, Seattle (Tsui); Albert Einstein College of Medicine, Montefiore Medical Center, New York City (Arnsten); Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston (Stotts); Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami (Horigian, Usaga); Hennepin Healthcare and Department of Medicine, University of Minnesota Medical School, Minneapolis (Bart); Veterans Affairs Puget Sound Health Care System, Seattle (Saxon); Manning College of Nursing and Health Sciences, University of Massachusetts, Boston (Thakral); Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena (Ling Grant); Genentech, Inc., San Francisco (Boudreau).
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Notes

Send correspondence to Dr. Braciszewski ([email protected]).
Data from this study were presented at the annual meeting of the College on Problems of Drug Dependence, San Diego, June 9–14, 2018.

Competing Interests

Drs. Braciszewski, Yarborough, Campbell, Loree, and Ling Grant and Mr. Stumbo have received support through their institution from the Industry PMR Consortium. Dr. Binswanger has received royalties from UpToDate, Inc. Dr. Bart has received honoraria from the American Academy of Addiction Psychiatry for participating in the Providers Clinical Support System Exchange. Dr. Saxon has received consulting fees and travel support from Alkermes, Inc.; consulting fees from Indivior, Inc.; and royalties from UpToDate, Inc. While employed at KPWHRI and conducting work for this study, Dr. Boudreau received funding from pharmaceutical companies that manufacture extended-release/long-acting opioids through a contract between KPWHRI and Syneos Health. The other authors report no financial relationships with commercial interests.

Funding Information

This study was sponsored by the National Institute on Drug Abuse (NIDA) through the following nodes and awards of the NIDA Clinical Trials Network: Health Systems Node (UG1 DA-040314), Northstar Node (UG1 DA-040316), Pacific Northwest Node (UG1 DA-013714), Florida Node Alliance (U10 DA-13720), Big South-West Node (UG1 DA-020024), and New York Node (UG1 DA-013035). Dr. Glass is supported by the National Institute on Alcohol Abuse and Alcoholism (award K01 AA-023859).The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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