Evaluating Filled Buprenorphine Prescriptions Following a Short-Duration Telementoring Program in Three Nevada Medicaid Managed Care Organizations.

BACKGROUND: Medications for opioid use disorder (MOUD) are an evidence-based treatment that significantly reduces the risk of overdose. Their underuse may be partly due to clinicians' lack of knowledge. In partnership with Nevada Medicaid Managed Care Organizations, the Project Extension for Community Healthcare Outcomes (ECHO) Nevada (PEN) used virtual telementoring to educate clinicians about MOUD and investigated whether this brief MOUD ECHO intervention increased filled buprenorphine prescriptions. METHODS: This retrospective cohort study evaluated a six-week program delivered through didactic and case-based learning sessions. Using 2 years of Nevada Medicaid managed care pharmacy claims (August 2022 through March 2024), we examined changes in filled buprenorphine prescriptions from 9 months before (August 2022-April 2023) to 9 months after (July 2023-March 2024) the ECHO program (May-June 2023). Adjusted logistic regression models among participating clinicians estimated the association between the post-intervention period and filled buprenorphine prescriptions (measured by pharmacy claims), adjusting for patient demographics and clinician prescribing volume. RESULTS: Among 10 ECHO participants writing 19 613 claims, filled buprenorphine prescriptions declined from 11.7 to 8.4 filled prescriptions per 1000 total filled prescriptions post-ECHO. However, in adjusted analyses among participants, ECHO participation was not associated with a significant change in the likelihood of a filled buprenorphine prescription (adjusted odds ratio 1.07; 95% CI, 0.76-1.51). CONCLUSIONS: A 6-week MOUD ECHO program was not associated with increased filled buprenorphine prescriptions among clinicians in Nevada. Findings suggest that short-duration ECHO interventions may be insufficient to influence complex behaviors related to medication for opioid use disorder.