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The PROUD (PRimary care Opioid Use Disorders treatment) trial demonstrated that implementation of primary care (PC) nurse care management increases OUD medication treatment compared with usual care (UC). This study assessed whether the PROUD intervention's effect differed across sex, race and ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Secondary analyses of cluster\u2010randomized implementation trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>12 PC clinics (2 per health system) in five states in the USA, randomized to UC or intervention, stratified by health system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>PC patients 16\u201390\u2009years old.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Three strategies to implement office\u2010based addiction treatment (OBAT) by nurse care managers: (1) full\u2010time nurse salary; (2) nurse training and technical assistance from expert nurses at Boston Medical Center; (3) \u22653 PC providers willing to prescribe buprenorphine. Nurses were trained in the Massachusetts model of OBAT which includes lowering barriers to OUD treatment, assessing and educating patients, supporting initiation of medications for OUD and providing ongoing medical management, in collaboration with PC providers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>The primary outcome was a clinic\u2010level measure of OUD treatment defined as patient\u2010years of OUD treatment per 10\u2009000 PC patients based on orders and procedures for buprenorphine or extended\u2010release naltrexone from electronic health records and insurance claims (hereafter \u2018OUD treatment\u2019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      The mean numbers of patients seen by intervention and UC clinics at baseline were 18\u2009485 and 22\u2009557, respectively. Female patients comprised 60% of the total PC population in intervention clinics and 64% in UC clinics; Asian, Black, Hispanic or smaller racial groups comprised 61% of the PC population in intervention clinics, and 70% in UC clinics. Compared with UC, the intervention increased OUD treatment for male patients [adjusted difference: 13.7 patient\u2010years; 95% confidence interval (CI) = 5.8\u201321.7], but not female patients (2.9; 95% CI = \u22124.3 to 10.2); effect modification test, F (1,14) = 4.77;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.046. Exploratory analyses suggest that differences in the intervention's effect on receipt of any OUD treatment in female and male patients, rather than differences in the duration of OUD treatment, may account for findings. There was no significant effect modification by race or ethnic group [effect modification test F (4,44) = 1.50;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.218].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Primary care clinics that implement office\u2010based addiction treatment by nurses increase patient\u2010years of opioid use disorder (OUD) treatment in male but not female patients. Exploratory findings suggest that differences in the proportion of patients treated for OUD, rather than differences in the duration of OUD treatment, account for observed differences across groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70221","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T05:20:58Z","timestamp":1764048058000},"page":"629-642","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Differences in benefits of office based opioid treatment: Secondary analyses across sub\u2010groups in the PROUD randomized controlled implementation trial"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1933-4425","authenticated-orcid":false,"given":"Katharine A.","family":"Bradley","sequence":"first","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute  Seattle WA USA"},{"name":"Division of General Internal Medicine, Department of Medicine University of Washington School of Medicine  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noorie","family":"Hyun","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abisola","family":"Idu","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onchee","family":"Yu","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer F.","family":"Bobb","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige D.","family":"Wartko","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute  Seattle WA USA"},{"name":"Department of Epidemiology, School of Public Health University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Weinstein","sequence":"additional","affiliation":[{"name":"Boston Medical Center Boston University Chobanian and Avedisian School of Medicine  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail G.","family":"Matthews","sequence":"additional","affiliation":[{"name":"The Emmes Company  Rockville MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"McCormack","sequence":"additional","affiliation":[{"name":"The Emmes Company  Rockville MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington Health Research Institute  Seattle WA USA"},{"name":"Department of Psychiatry and Behavioral Sciences University of Washington, School of Medicine  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey H.","family":"Samet","sequence":"additional","affiliation":[{"name":"Boston Medical Center Boston University Schools of Medicine and Public Health  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the PROUD Trial collaborators on sex, race and ethnicity","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n784"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.4104"},{"key":"e_1_2_11_4_1","volume-title":"Medications for opioid use disorder save lives","author":"National Academies of Sciences Engineering Medicine","year":"2019"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-018-0094-5"},{"key":"e_1_2_11_6_1","unstructured":"VolkowN.Five areas where \u201cmore research\u201d isn't needed to curb the overdose crisis. 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