{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:43:12Z","timestamp":1785544992180,"version":"3.56.0"},"reference-count":99,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Many substance use disorder (SUD) care pathways exist in health care systems. However, patients with SUD often report poor care experiences, particularly regarding timely follow-up, clinician and general satisfaction ratings, and care communication. As SUD care pathways involve transitions across clinicians and venues of care, adequate treatment requires coordination across clinicians and settings to ensure unmet needs are addressed, and appropriate SUD care is delivered. Surprisingly little is known about the real-world care pathways patients engage in once identified as having SUD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study protocol describes research that will comprehensively characterize the pathways of care used by those who obtain care for SUD and compare the quality and outcomes associated with these care pathways. Specific aims are to (1) apply multistate models (MSM) to characterize the spectrum of care transitions among patients with SUD within a large integrated health system, (2) generate data-driven insights to improve care delivery for SUD using estimated MSMs, and (3) observe and explore patient and clinician experiences with care transitions across common care pathways using qualitative methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Quantitative data sources will include electronic health care records, insurance claims, self-reported measures of substance use and SUD symptoms, and death data from an integrated health care system in Washington State. To identify care pathways, we will apply continuous time, multistate modeling methods to empirically observe the longitudinal course of SUD care transitions undertaken by patients over time; each \u201cstate\u201d or occurrence of care will be characterized by the intervention received (eg, evaluation or assessment, behavioral treatment or counseling, and pharmacotherapy) and setting of care (eg, outpatient, intensive outpatient, or inpatient or residential). The estimated parameters from the fitted MSMs will be transformed or interpreted to characterize SUD care quality, such as wait times for SUD visits, and receiving an adequate psychotherapy dose. To compare outcomes associated with care pathways, we will examine terminal states, including death and loss to follow-up. Using a mixed methods design, we will sample and interview patients engaged in empirically derived pathways to understand their care experiences, observe and interview clinicians to elucidate health system factors that impact SUD care transitions, and integrate qualitative and quantitative findings using joint displays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study was funded in June 2025 and received institutional review board approval on July 17, 2025. We expect preliminary data collection for quantitative analyses to be complete by May 2026, and final data collection will be complete by November 2027. We expect qualitative data collection completion by November 2029.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This exploratory study will identify and compare the quality and outcomes associated with common pathways that patients take when they obtain treatment for SUD and provide decision-makers with information on how to better organize SUD care delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/93043","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T07:50:05Z","timestamp":1776757805000},"page":"e93043-e93043","source":"Crossref","is-referenced-by-count":0,"title":["Using Multistate Models and Qualitative Interviews to Comprehensively Characterize Substance Use Disorder Care Transitions in a US Health Care System: Protocol for a Mixed-Methods Study"],"prefix":"10.2196","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2923-3698","authenticated-orcid":false,"given":"Joseph E","family":"Glass","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6079-686X","authenticated-orcid":false,"given":"Edwin S","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1478-5238","authenticated-orcid":false,"given":"Tara C","family":"Beatty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4744-5897","authenticated-orcid":false,"given":"Jennifer F","family":"Bobb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5445-8119","authenticated-orcid":false,"given":"Randall","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3419-4539","authenticated-orcid":false,"given":"Paul","family":"Fishman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1872-9416","authenticated-orcid":false,"given":"Abisola","family":"Idu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7787-2613","authenticated-orcid":false,"given":"Jubi Y L","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4551-7981","authenticated-orcid":false,"given":"Theresa E","family":"Matson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4736-5990","authenticated-orcid":false,"given":"Lorella","family":"Palazzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5974-8174","authenticated-orcid":false,"given":"Arvind","family":"Ramaprasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1838-4981","authenticated-orcid":false,"given":"Zelda B","family":"Zabinsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8923-1184","authenticated-orcid":false,"given":"Noorie","family":"Hyun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1177\/11782218221111832","article-title":"Rethinking unhealthy alcohol use in the United States: a structured review","volume":"16","author":"Volpicelli","journal-title":"Subst Abuse"},{"issue":"7","key":"R2","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1007\/s11606-016-3614-5","article-title":"Alcohol screening and intervention among United States adults who attend ambulatory healthcare","volume":"31","author":"Glass","journal-title":"J Gen Intern Med"},{"key":"R3","unstructured":"Key substance use and mental health indicators in the United States: results from the 2022 National Survey on Drug Use and Health (NSDUH): summary of national findings. Substance Abuse and Mental Health Services Administration (SAMHSA); 2023. URL: https:\/\/www.samhsa.gov\/data\/report\/2022-nsduh-annual-national-report"},{"issue":"2","key":"R4","doi-asserted-by":"publisher","first-page":"108102","DOI":"10.1016\/j.amepre.2025.108102","article-title":"Productivity losses from substance use disorder in the U.S. in 2023","volume":"70","author":"Ghimire","journal-title":"Am J Prev Med"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.52378","article-title":"Medical costs of substance use disorders in the US employer-sponsored insurance population","volume":"6","author":"Li","journal-title":"JAMA Netw Open"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108382","article-title":"The cost of opioid use disorder and the value of aversion","volume":"217","author":"Murphy","journal-title":"Drug Alcohol Depend"},{"issue":"5","key":"R7","doi-asserted-by":"publisher","first-page":"e73","DOI":"10.1016\/j.amepre.2015.05.031","article-title":"2010 national and state costs of excessive alcohol consumption","volume":"49","author":"Sacks","journal-title":"Am J Prev Med"},{"issue":"10469","key":"R8","doi-asserted-by":"publisher","first-page":"2314","DOI":"10.1016\/S0140-6736(24)01446-6","article-title":"The burden of diseases, injuries, and risk factors by state in the USA, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"404","author":"GBD 2021 US Burden of Disease Collaborators","journal-title":"Lancet"},{"issue":"8","key":"R9","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1176\/appi.ajp.2013.12060782","article-title":"DSM-5 criteria for substance use disorders: recommendations and rationale","volume":"170","author":"Hasin","journal-title":"Am J Psychiatry"},{"key":"R10","doi-asserted-by":"crossref","unstructured":"Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013. [doi: 10.1176\/appi.books.9780890425596]","DOI":"10.1176\/appi.books.9780890425596"},{"key":"R11","unstructured":"Drug overdose deaths: facts and figures. National Institute on Drug Abuse. URL: https:\/\/nida.nih.gov\/research-topics\/trends-statistics\/overdose-death-rates [Accessed 02-05-2026]"},{"issue":"12","key":"R12","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1016\/S2215-0366(18)30337-7","article-title":"The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"5","author":"Degenhardt","journal-title":"Lancet Psychiatry"},{"issue":"3","key":"R13","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1300\/J465v28n03_03","article-title":"Screening, brief intervention, and referral to treatment (SBIRT): toward a public health approach to the management of substance abuse","volume":"28","author":"Babor","journal-title":"Subst Abus"},{"issue":"22","key":"R14","doi-asserted-by":"publisher","first-page":"2301","DOI":"10.1001\/jama.2020.8020","article-title":"Screening for unhealthy drug use: US preventive services task force recommendation statement","volume":"323","author":"US Preventive Services Task Force","journal-title":"JAMA"},{"issue":"12","key":"R15","volume":"89","journal-title":"Am Fam Physician"},{"issue":"6","key":"R16","doi-asserted-by":"publisher","first-page":"e159","DOI":"10.37765\/ajmc.2025.89752","article-title":"Challenges faced by Medicaid managed care coordinators working with members with substance use disorder","volume":"31","author":"Marks","journal-title":"Am J Manag Care"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1089\/heq.2018.0069","article-title":"Substance use disorder-related disparities in patient experiences of primary care","volume":"3","author":"Hoggatt","journal-title":"Health Equity"},{"issue":"2","key":"R18","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1111\/add.14793","article-title":"Dropout rates of in-person psychosocial substance use disorder treatments: a systematic review and meta-analysis","volume":"115","author":"Lappan","journal-title":"Addiction"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/0272-7358(92)90092-M","article-title":"Dropping out of substance abuse treatment: a clinically oriented review","volume":"12","author":"Stark","journal-title":"Clin Psychol Rev"},{"issue":"2","key":"R20","doi-asserted-by":"publisher","DOI":"10.1007\/BF03391707","article-title":"Can substance use disorders be managed using the chronic care model? Review and recommendations from a NIDA consensus group","volume":"35","author":"McLellan","journal-title":"Public Health Rev"},{"issue":"13","key":"R21","doi-asserted-by":"publisher","first-page":"1689","DOI":"10.1001\/jama.284.13.1689","article-title":"Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation","volume":"284","author":"McLellan","journal-title":"JAMA"},{"key":"R22","unstructured":"Valdez RS Ramly E Brennan PF . Industrial and systems engineering and health care: critical areas of research--final report. Agency for Healthcare Research and Quality; May 2010. URL: https:\/\/digital.ahrq.gov\/sites\/default\/files\/docs\/citation\/IndustrialAndSystemsEngineeringAndHealthCare.pdf [Accessed 02-05-2026]"},{"key":"R23","doi-asserted-by":"crossref","unstructured":"Kampen NG . Markov processes. In: Stochastic Processes in Physics and Chemistry Elsevier. 3rd ed. North-Holland Personal Library; 2007:73-95. [doi: 10.1016\/B978-044452965-7\/50007-6] ISBN: 978-0-444-52965-7","DOI":"10.1016\/B978-044452965-7\/50007-6"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2015.01.012","article-title":"Latent class analysis of alcohol treatment utilization patterns and 3-year alcohol related outcomes","volume":"54","author":"Mowbray","journal-title":"J Subst Abuse Treat"},{"issue":"2","key":"R25","doi-asserted-by":"publisher","first-page":"S63","DOI":"10.1016\/j.jsat.2004.09.006","article-title":"Pathways in the relapse--treatment--recovery cycle over 3 years","volume":"28 Suppl 1","author":"Scott","journal-title":"J Subst Abuse Treat"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2019.07.013","article-title":"Modelling long-term joint trajectories of heroin use and treatment utilisation: findings from the Australian Treatment Outcome Study","volume":"14","author":"Marel","journal-title":"EClinicalMedicine"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108632","article-title":"Predicting longitudinal service use for individuals with substance use disorders: a latent profile analysis","volume":"132","author":"Crable","journal-title":"J Subst Abuse Treat"},{"issue":"2","key":"R28","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.20622","article-title":"Comparative effectiveness of different treatment pathways for opioid use disorder","volume":"3","author":"Wakeman","journal-title":"JAMA Netw Open"},{"issue":"1","key":"R29","first-page":"2","volume":"1","author":"Wagner","journal-title":"Eff Clin Pract"},{"key":"R30","unstructured":"About Kaiser Permanente Washington. Kaiser Permanente. URL: https:\/\/wa.kaiserpermanente.org\/html\/public\/about [Accessed 02-05-2026]"},{"issue":"5","key":"R31","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1377\/hlthaff.2010.0158","article-title":"The group health medical home at year two: cost savings, higher patient satisfaction, and less burnout for providers","volume":"29","author":"Reid","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-018-0795-9","article-title":"Study protocol: a cluster-randomized trial implementing Sustained Patient-Centered Alcohol-Related Care (SPARC trial)","volume":"13","author":"Glass","journal-title":"Implement Sci"},{"issue":"1","key":"R33","doi-asserted-by":"publisher","first-page":"108112","DOI":"10.1016\/j.amepre.2025.108112","article-title":"Implementing care for cannabis and other drug use in adult primary care: outcomes of a cluster-randomized implementation trial","volume":"70","author":"Matson","journal-title":"Am J Prev Med"},{"issue":"4","key":"R34","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1001\/jamainternmed.2022.7083","article-title":"Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial","volume":"183","author":"Lee","journal-title":"JAMA Intern Med"},{"issue":"5","key":"R35","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1016\/j.amepre.2008.01.028","article-title":"Effect of incentives and mailing features on online health program enrollment","volume":"34","author":"Alexander","journal-title":"Am J Prev Med"},{"key":"R36","unstructured":"Initiation and engagement of substance use disorder treatment (IET). National Committee for Quality Assurance. URL: https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/initiation-and-engagement-of-substance-use-disorder-treatment-iet\/ [Accessed 02-05-2026]"},{"issue":"1-2","key":"R37","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.drugalcdep.2010.06.003","article-title":"Prevalence and correlates of specialty substance use disorder treatment for Department of Veterans Affairs healthcare system patients with high alcohol consumption","volume":"112","author":"Glass","journal-title":"Drug Alcohol Depend"},{"key":"R38","unstructured":"Chapter 43.371 RCW: statewide health care claims data. Washington State Legislature. URL: https:\/\/app.leg.wa.gov\/rcw\/default.aspx?cite=43.371&full=true [Accessed 02-05-2026]"},{"issue":"9","key":"R39","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14091030","article-title":"Evaluation of a pilot implementation to integrate alcohol-related care within primary care","volume":"14","author":"Bobb","journal-title":"Int J Environ Res Public Health"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.04.015","article-title":"Integration of screening, assessment, and treatment for cannabis and other drug use disorders in primary care: an evaluation in three pilot sites","volume":"201","author":"Richards","journal-title":"Drug Alcohol Depend"},{"key":"R41","unstructured":"Diagnostic and Statistical Manual of Mental Disorders. 4th ed. American Psychiatric Association; 2000. ISBN: 0-89042-062-9"},{"issue":"5","key":"R42","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.16283","article-title":"Psychometric performance of a substance use symptom checklist to help clinicians assess substance use disorder in primary care","volume":"6","author":"Matson","journal-title":"JAMA Netw Open"},{"issue":"3","key":"R43","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1111\/acer.14778","article-title":"Practical assessment of DSM-5 alcohol use disorder criteria in routine care: high test-retest reliability of an alcohol symptom checklist","volume":"46","author":"Hallgren","journal-title":"Alcohol Clin Exp Res"},{"issue":"12","key":"R44","doi-asserted-by":"publisher","first-page":"2169","DOI":"10.1007\/s11606-024-08845-0","article-title":"Assessing substance use disorder symptoms with a checklist among primary care patients with opioid use disorder and\/or long-term opioid treatment: an observational study","volume":"39","author":"Williams","journal-title":"J Gen Intern Med"},{"key":"R45","unstructured":"HEDIS measurement year 2020 & measurement year 2021. National Committee for Quality Assurance; 2020."},{"key":"R46","unstructured":"HEDIS MY 2023 Quality Rating System (QRS) value set directory. National Committee for Quality Assurance. URL: https:\/\/store.ncqa.org\/my-2023-quality-rating-system-qrs-hedis-value-set-directory.html [Accessed 02-05-2026]"},{"issue":"1","key":"R47","doi-asserted-by":"publisher","DOI":"10.5334\/egems.280","article-title":"Data quality assessment and multi-organizational reporting: tools to enhance network knowledge","volume":"7","author":"Sengupta","journal-title":"EGEMS (Wash DC)"},{"key":"R48","unstructured":"Diversity demographic data collection. Kaiser Permanente. URL: https:\/\/healthy.kaiserpermanente.org\/content\/dam\/kporg\/final\/documents\/directories\/resource-guides\/diversity-data-demographic-collection-en.pdf [Accessed 02-05-2026]"},{"key":"R49","unstructured":"AHRQ community-level health database. NYU Langone Health. URL: https:\/\/datacatalog.med.nyu.edu\/dataset\/10665 [Accessed 02-05-2026]"},{"key":"R50","unstructured":"Arons A DeSilvey S Fichtenberg C Gottlieb L . Compendium of medical terminology codes for social risk factors. Social Interventions Research and Evaluation Network. URL: https:\/\/sirenetwork.ucsf.edu\/tools-resources\/resources\/compendium-medical-terminology-codes-social-risk-factors [Accessed 02-05-2026]"},{"key":"R51","unstructured":"American community survey 5-year data (2009-2024). United States Census Bureau. URL: https:\/\/www.census.gov\/data\/developers\/data-sets\/acs-5year.html [Accessed 02-05-2026]"},{"key":"R52","volume":"112","author":"Fredriksson","journal-title":"Lakartidningen"},{"issue":"1","key":"R53","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.healthpol.2011.09.004","article-title":"Multimorbidity and its measurement","volume":"103","author":"Starfield","journal-title":"Health Policy"},{"key":"R54","unstructured":"The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization. Jan 1, 1992. URL: https:\/\/www.who.int\/publications\/i\/item\/9241544228 [Accessed 02-05-2026]"},{"issue":"2","key":"R55","doi-asserted-by":"publisher","first-page":"93","DOI":"10.31887\/DCNS.2017.19.2\/bbandelow","article-title":"Treatment of anxiety disorders","volume":"19","author":"Bandelow","journal-title":"Dialogues Clin Neurosci"},{"issue":"8","key":"R56","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1176\/appi.ps.202100499","article-title":"Serious mental illness diagnosis and COVID-19 vaccine uptake in the veterans health administration","volume":"73","author":"Haderlein","journal-title":"Psychiatr Serv"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2023.109821","article-title":"Association between clinical measures of unhealthy alcohol use and subsequent year hospital admissions in a primary care population","volume":"245","author":"Jack","journal-title":"Drug Alcohol Depend"},{"key":"R58","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2016.11.017","article-title":"The number of primary events per variable affects estimation of the subdistribution hazard competing risks model","volume":"83","author":"Austin","journal-title":"J Clin Epidemiol"},{"issue":"1","key":"R59","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-023-01905-9","article-title":"Exploring different research questions via complex multi-state models when using registry-based repeated prescriptions of antidepressants in women with breast cancer and a matched population comparison group","volume":"23","author":"Skourlis","journal-title":"BMC Med Res Methodol"},{"issue":"15","key":"R60","doi-asserted-by":"publisher","first-page":"2175","DOI":"10.1002\/sim.1203","article-title":"Flexible parametric proportional-hazards and proportional-odds models for censored survival data, with application to prognostic modelling and estimation of treatment effects","volume":"21","author":"Royston","journal-title":"Stat Med"},{"issue":"8","key":"R61","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0200807","article-title":"Comparison of the flexible parametric survival model and Cox model in estimating Markov transition probabilities using real-world data","volume":"13","author":"Du","journal-title":"PLoS One"},{"issue":"4","key":"R62","doi-asserted-by":"crossref","first-page":"855","DOI":"10.2307\/2530699","volume":"42","author":"Kay","journal-title":"Biometrics"},{"issue":"392","key":"R63","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1080\/01621459.1985.10478195","article-title":"The analysis of panel data under a Markov assumption","volume":"80","author":"Kalbfleisch","journal-title":"J Am Stat Assoc"},{"issue":"4","key":"R64","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1002\/psp4.13109","article-title":"Application of multistate modeling to clinical data analysis","volume":"13","author":"Grevel","journal-title":"CPT Pharmacometrics Syst Pharmacol"},{"issue":"11","key":"R65","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1093\/aje\/kww112","article-title":"Controlling for informed presence bias due to the number of health encounters in an electronic health record","volume":"184","author":"Goldstein","journal-title":"Am J Epidemiol"},{"key":"R66","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.09.003","article-title":"Substance use and mental diagnoses among adults with and without type 2 diabetes: results from electronic health records data","volume":"156","author":"Wu","journal-title":"Drug Alcohol Depend"},{"issue":"8","key":"R67","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v038.i08","article-title":"Multi-state models for panel data: the msm package for R","volume":"38","author":"Jackson","journal-title":"J Stat Soft"},{"key":"R68","doi-asserted-by":"crossref","unstructured":"G\u00f3mez-Corral A Lopez-Herrero MJ Rodr\u00edguez-Bernal MT . On first passage times in discrete skeletons and uniformized versions of a continuous-time Markov chain. In: Balakrishnan N Gil M\u00c1 Mart\u00edn N Morales D Pardo MDC , editors. Trends in Mathematical, Information and Data Sciences. Springer International Publishing; 2023:29-37. [doi: 10.1007\/978-3-031-04137-2_4] ISBN: 978-3-031-04136-5","DOI":"10.1007\/978-3-031-04137-2_4"},{"issue":"5","key":"R69","doi-asserted-by":"publisher","first-page":"495","DOI":"10.3348\/kjr.2022.0061","article-title":"Restricted mean survival time for survival analysis: a quick guide for clinical researchers","volume":"23","author":"Han","journal-title":"Korean J Radiol"},{"key":"R70","unstructured":"Overview of substance use disorder measures in the 2024 child, adult, and health home core sets. Medicaid & CHIP. Feb 2024. URL: https:\/\/www.medicaid.gov\/medicaid\/quality-of-care\/downloads\/factsheet-sud-adult-core-set.pdf [Accessed 02-05-2026]"},{"key":"R71","unstructured":"Follow-up after high-intensity care for substance use disorder (FUI). National Committee for Quality Assurance. URL: https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/follow-up-after-high-intensity-care-for-substance-use-disorder-fui\/ [Accessed 02-05-2026]"},{"issue":"4","key":"R72","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1097\/ADM.0000000000000408","article-title":"Applying American Society of Addiction Medicine performance measures in commercial health insurance and services data","volume":"12","author":"Thomas","journal-title":"J Addict Med"},{"issue":"3","key":"R73","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1097\/ADM.0000000000000203","article-title":"Specifying and pilot testing quality measures for the American Society of Addiction Medicine\u2019s standards of care","volume":"10","author":"Harris","journal-title":"J Addict Med"},{"key":"R74","doi-asserted-by":"publisher","DOI":"10.1016\/j.pecinn.2022.100036","article-title":"Direct observation methods: a practical guide for health researchers","volume":"1","author":"Fix","journal-title":"PEC Innov"},{"issue":"3","key":"R75","doi-asserted-by":"publisher","DOI":"10.4081\/qrmh.2021.9821","article-title":"Using observation to better understand the healthcare context","volume":"5","author":"Weston","journal-title":"Qual Res Med Healthc"},{"issue":"5","key":"R76","doi-asserted-by":"publisher","first-page":"607","DOI":"10.4300\/JGME-D-21-00752.1","article-title":"Beyond the guise of saturation: rigor and qualitative interview data","volume":"13","author":"LaDonna","journal-title":"J Grad Med Educ"},{"key":"R77","unstructured":"Goodall HL . Writing the New Ethnography. AltaMira Press; 2000. ISBN: 9780742503380"},{"key":"R78","unstructured":"Green J Skukauskaite A Baker W . Ethnography as epistemology: an introduction to educational ethnography. In: Research Methods and Methodologies in Education. SAGE Publications; 2012:309-321. URL: https:\/\/www.readinghalloffame.org\/sites\/default\/files\/green_sku_baker_ethnog.pdf [Accessed 02-05-2026]"},{"key":"R79","doi-asserted-by":"crossref","unstructured":"Markee N . Emic and etic in qualitative research. In: Chapelle CA , editor. The Encyclopedia of Applied Linguistics. 1st ed. Wiley; 2012:1-4. [doi: 10.1002\/9781405198431] ISBN: 978-1-4051-9473-0","DOI":"10.1002\/9781405198431"},{"issue":"6 Pt 2","key":"R80","doi-asserted-by":"publisher","first-page":"2134","DOI":"10.1111\/1475-6773.12117","article-title":"Achieving integration in mixed methods designs-principles and practices","volume":"48","author":"Fetters","journal-title":"Health Serv Res"},{"key":"R81","unstructured":"Bernard HR . Research Methods in Anthropology: Qualitative and Quantitative Approaches. Rowman & Littlefield; 2017. ISBN: 9781538190944"},{"key":"R82","doi-asserted-by":"crossref","unstructured":"Quinlan MB . The freelisting method. In: Liamputtong P , editor. Handbook of Research Methods in Health Social Sciences. Springer Singapore; 2017:1-16. [doi: 10.1007\/978-981-10-2779-6_12-1] ISBN: 978-981-10-2779-6","DOI":"10.1007\/978-981-10-2779-6_12-1"},{"key":"R83","doi-asserted-by":"crossref","unstructured":"Weller SC Romney AK . Systematic Data Collection. SAGE Publications, Inc; 2024. [doi: 10.4135\/9781412986069]","DOI":"10.4135\/9781412986069"},{"issue":"3","key":"R84","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1177\/1525822X05277460","article-title":"Considerations for collecting freelists in the field: examples from ethobotany","volume":"17","author":"Quinlan","journal-title":"Field methods"},{"key":"R85","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.11.005","article-title":"Perceptions about supervised injection facilities among people who inject drugs in Philadelphia","volume":"52","author":"Harris","journal-title":"Int J Drug Policy"},{"key":"R86","doi-asserted-by":"crossref","unstructured":"Quinlan MB . The freelisting method. In: Liamputtong P , editor. Handbook of Research Methods in Health Social Sciences. Springer Singapore; 2019:1431-1446. [doi: 10.1007\/978-981-10-5251-4_12] ISBN: 978-981-10-5251-4","DOI":"10.1007\/978-981-10-5251-4_12"},{"issue":"3","key":"R87","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1016\/j.jpainsymman.2019.10.029","article-title":"When patients take charge of opioids: self-management concerns and practices among cancer outpatients in the context of opioid crisis","volume":"59","author":"Meghani","journal-title":"J Pain Symptom Manage"},{"key":"R88","doi-asserted-by":"publisher","DOI":"10.5888\/pcd17.200355","article-title":"Practical guidance for studies using freelisting interviews","volume":"18","author":"Keddem","journal-title":"Prev Chronic Dis"},{"issue":"1","key":"R89","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-023-00387-w","article-title":"Implementation and workflow strategies for integrating digital therapeutics for alcohol use disorders into primary care: a qualitative study","volume":"18","author":"Mogk","journal-title":"Addict Sci Clin Pract"},{"issue":"1","key":"R90","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-023-00382-1","article-title":"Treating opioid use disorder in veterans with co-occurring substance use: a qualitative study with buprenorphine providers in primary care, mental health, and pain settings","volume":"18","author":"Frost","journal-title":"Addict Sci Clin Pract"},{"key":"R91","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114523","article-title":"Sample sizes for saturation in qualitative research: a systematic review of empirical tests","volume":"292","author":"Hennink","journal-title":"Soc Sci Med"},{"issue":"9","key":"R92","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","journal-title":"Qual Health Res"},{"key":"R93","unstructured":"Saldana JM . The Coding Manual for Qualitative Researchers. SAGE Publications; 2021. ISBN: 978-1-5297-5598-5"},{"issue":"4","key":"R94","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1177\/0894439307312485","article-title":"Utilizing qualitative data analysis software","volume":"26","author":"Hwang","journal-title":"Soc Sci Comput Rev"},{"key":"R95","doi-asserted-by":"publisher","DOI":"10.2466\/03.CP.3.4","article-title":"Achieving saturation in thematic analysis: development and refinement of a codebook","volume":"3","author":"Ando","journal-title":"Compr Psychol"},{"issue":"5 Pt 2","key":"R96","first-page":"1189","volume":"34","author":"Patton","journal-title":"Health Serv Res"},{"issue":"5","key":"R97","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1188\/14.ONF.545-547","article-title":"The use of triangulation in qualitative research","volume":"41","author":"Carter","journal-title":"Oncol Nurs Forum"},{"issue":"3","key":"R98","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1177\/20597991231188121","article-title":"Generating metainferences in mixed methods research: a worked example in convergent mixed methods designs","volume":"16","author":"Younas","journal-title":"Methodol Innovations"},{"issue":"6","key":"R99","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1097\/ADM.0000000000000246","article-title":"Under-reporting of risky drug use among primary care patients in federally qualified health centers","volume":"10","author":"Bone","journal-title":"J Addict Med"}],"container-title":["JMIR Research Protocols"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.researchprotocols.org\/2026\/1\/e93043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:23:48Z","timestamp":1785536628000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.researchprotocols.org\/2026\/1\/e93043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,28]]},"references-count":99,"URL":"https:\/\/doi.org\/10.2196\/93043","relation":{},"ISSN":["1929-0748"],"issn-type":[{"value":"1929-0748","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,28]]},"article-number":"v15i7e93043"}}