{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T07:06:07Z","timestamp":1780643167174,"version":"3.54.1"},"reference-count":46,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["1IK2HX003007"],"award-info":[{"award-number":["1IK2HX003007"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["CIN 13\u2010404"],"award-info":[{"award-number":["CIN 13\u2010404"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe a learning health care system research process designed to increase buprenorphine prescribing for the treatment of opioid use disorder (OUD) in rural primary care settings within U.S. Department of Veterans Affairs (VA) treatment facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Study Setting<\/jats:title>\n                    <jats:p>Using national administrative data from the VA Corporate Data Warehouse, we identified six rural VA health care systems that had improved their rate of buprenorphine prescribing within primary care from 2015 to 2020 (positive deviants). We conducted qualitative interviews with leaders, clinicians, and staff involved in buprenorphine prescribing within primary care from these sites to inform the design of an implementation strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Qualitative interviews to inform implementation strategy development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection\/Extraction Methods<\/jats:title>\n                    <jats:p>Interviews were audio\u2010recorded, transcribed verbatim, and coded by a primary coder and secondary reviewer. Analysis utilized a mixed inductive\/deductive approach. To develop an implementation strategy, we matched clinical needs identified within interviews with resources and strategies participants had utilized to address these needs in their own sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>\n                      Interview participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930) identified key clinical needs and strategies for implementing buprenorphine in rural, primary care settings. Common suggestions included the need for clinical mentorship or a consult service, buprenorphine training, and educational resources. Building upon interview findings and in partnership with a clinical team, we developed an implementation strategy composed of an engaging case\u2010based training, an audit and feedback process, and educational resources (e.g., Buprenorphine Frequently Asked Questions, Rural Care Model Infographic).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We describe a learning health care system research process that leveraged national administrative data, health care provider interviews, and clinical partnership to develop an implementation strategy to encourage buprenorphine prescribing in rural primary care settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1475-6773.14346","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T07:58:52Z","timestamp":1719907132000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Improving access to buprenorphine for rural veterans in a learning health care system"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4789-4390","authenticated-orcid":false,"given":"Jessica J.","family":"Wyse","sequence":"first","affiliation":[{"name":"Center to Improve Veteran Involvement in Care VA Portland Health Care System  Portland Oregon USA"},{"name":"School of Public Health Oregon Health &amp; Science University\u2010Portland State University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Mackey","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care VA Portland Health Care System  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim A.","family":"Kauzlarich","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care VA Portland Health Care System  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J.","family":"Morasco","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care VA Portland Health Care System  Portland Oregon USA"},{"name":"Department of Psychiatry Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9261-7742","authenticated-orcid":false,"given":"Kathleen F.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care VA Portland Health Care System  Portland Oregon USA"},{"name":"School of Public Health Oregon Health &amp; Science University\u2010Portland State University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Informatics, Decision\u2010Enhancement, and Analytic Sciences (IDEAS) Center VA Salt Lake City Health Care System  Salt Lake City Utah USA"},{"name":"Division of Epidemiology, Department of Internal Medicine University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. Todd","family":"Korthuis","sequence":"additional","affiliation":[{"name":"School of Public Health Oregon Health &amp; Science University\u2010Portland State University  Portland Oregon USA"},{"name":"Department of Medicine Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Eckhardt","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care VA Portland Health Care System  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Summer","family":"Newell","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care VA Portland Health Care System  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah S.","family":"Ono","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care VA Portland Health Care System  Portland Oregon USA"},{"name":"Department of Psychiatry Oregon Health &amp; Science University  Portland Oregon USA"},{"name":"VA Office of Rural Health Veterans Rural Health Resource Center\u2010Portland  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis I.","family":"Lovejoy","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care VA Portland Health Care System  Portland Oregon USA"},{"name":"School of Public Health Oregon Health &amp; Science University\u2010Portland State University  Portland Oregon USA"},{"name":"Department of Psychiatry Oregon Health &amp; Science University  Portland Oregon USA"},{"name":"VA Office of Rural Health Veterans Rural Health Resource Center\u2010Portland  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2022.100052"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.34540"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.36864"},{"key":"e_1_2_10_5_1","unstructured":"CDC.U.S. overdose deaths in 2021 increased half as much as in 2020\u2014but are still up 15%. 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