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Objective: Buprenorphine, a medication for opioid use disorder, remains vastly underutilized despite its proven efficacy. This study sought to evaluate which strategies, within a system that employed a variety of concurrent strategies, effectively increased access to buprenorphine.

Methods: Over the course of 15 months, 25 federally qualified health centers were invited to participate in four commonly used implementation strategies. This study examines the impact of clinic attendance at strategy events on change in numbers of patients prescribed buprenorphine and numbers of buprenorphine-waivered providers by clinic.

Results: There was a nearly three-fold increase (2.84) in patients on buprenorphine and two-fold increase (1.90) in number of buprenorphine-waivered prescribers during the project period. Clinics attending at least half of the available didactic webinars and Project ECHO sessions were significantly more likely to increase both patients and providers, respectively, than clinics attending fewer events.

Conclusions: In order to make informed decisions about how best to increase access to medications for opioid use disorder, systems and organizations need data on which implementation strategy options are most effective.