Table 1 Summary of Intervention Provider Roles and Timing of Patient Contacts
Team member | PCP | NCM | Telephone Health Coach |
|---|---|---|---|
Role and responsibilities | • Brief advice • Discusses opioid use in context of overall health | • Health education • Risk reduction counseling • Overdose prevention and naloxone provision • Self-management skills • Education on non-pharmacologic pain management • Referrals and support for pain, mental health, SUD treatment, other services • Healthcare and resource navigation • Supports engagement in primary care • Uses motivational enhancement strategies to engage patients in SUD treatment when indicated • Monitoring opioid prescribing and risks, when applicable | 2 initial coaching sessions • Offers support • Evidence-based counseling (MI) to enhance motivation for substance use behavior change • Risk reduction counseling • Suggests strategies for overcoming barriers to behavior change • Encourages engagement w/ primary care and behavioral health providers and study nurse care manager in the clinic • Encourages utilization of community and/or on-line resources to support behavior change 4 enhanced coaching sessions: • Evidence-based CBT focused on substance use behavior change • Additional CBT to address other patient concerns (Pain, Depression, Anxiety) |
Timing of patient contacts | 1.Baseline visit or within 10 business days 2.Readdress in follow-up primary care visits | 1.Baseline visit 2.12Â months of ongoing monitoring and engagement in conjunction with PCP. Meets on an approximately monthly basis for patients prescribed chronic opioids and as needed for all patients | 1.Initial health coaching: Week 2 and Week 4 (approximately) following baseline visit 2.Enhanced coaching: For individuals who may benefit from further intervention: Weeks 7,8,9,10 (approximately) |
Location | Clinic, video visit, or telephone visit | Clinic (contacts are in-person ± by telephone) | Telephone and/or video |