# Examining injectable buprenorphine implementation strategies in low-threshold and primary care settings

> **NIH NIH K23** · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2024 · $195,696

## Abstract

ABSTRACT
In this K23 proposal, Dr. Andrea Jakubowski, an addiction medicine physician, describes a 4-year mentored
research project and a rigorous career development plan that will help establish her as an independent
clinician investigator who uses implementation science (IS) to design and study interventions to improve the
health of people with opioid use disorder (OUD). Injectable buprenorphine (iBUPE) is a safe, evidence-based
treatment for OUD that provides continuous levels of buprenorphine for 4-6 weeks. Clinical trials with iBUPE
demonstrate high treatment retention, reductions in illicit opioid use, and improvements in quality of life for
persons with OUD. iBUPE may be especially useful for patients with psychosocial barriers to self-administering
daily sublingual buprenorphine, the most commonly prescribed formulation. However, there is limited iBUPE
uptake in real-world settings, likely due to health systems and patient level barriers. Thus, in a rigorous
implementation study, over a 30-month period, we will use well-established IS methods to implement iBUPE in
one primary care clinic and one "low-threshold" clinic (based in a syringe services program) with the following
aims: Aim 1: To identify iBUPE pre-implementation determinants and develop implementation
strategies; Aim 2: To pilot, refine, and evaluate iBUPE implementation strategies; Aim 3: To examine
gaps in care following iBUPE implementation. For Aim 1, guided by Consolidated Framework for
Implementation Research, we will use data from focus groups with staff and persons with OUD to identify
iBUPE pre-implementation determinants. We will then develop and select implementation strategies that
address these determinants. For Aim 2, we will use rapid cycle testing to pilot and refine implementation
strategies. We will then use the Proctor framework to evaluate implementation outcomes (acceptability,
adoption, feasibility and fidelity) using staff focus groups and data from study logs and the electronic health
record (EHR). In Aim 3, we will use EHR data to establish "cascades of care" for iBUPE treatment, identifying
gaps in iBUPE delivery beginning with interest in iBUPE and ending with treatment retention at 6 months. We
will examine patient-level barriers that contribute to gaps in the care cascade by conducting 40-80 qualitative
interview with patients who are offered iBUPE then experience different outcomes (decline iBUPE, interested
but do not initiate, initiate but are not retained in treatment at 3 months, initiate and are retained at 6 months).
We will use these data to develop generalizable iBUPE implementation manuals that we will test in a future
R01 study of scaling iBUPE implementation in a network of LT and PC clinics. To accomplish these aims, Dr.
Jakubowski will pursue training in application of IS frameworks, qualitative methods for IS research, and
stakeholder-engaged research. In doing so, she will achieve her goal of becoming an independent clinician
investi...

## Key facts

- **NIH application ID:** 10873766
- **Project number:** 5K23DA052627-02
- **Recipient organization:** ALBERT EINSTEIN COLLEGE OF MEDICINE
- **Principal Investigator:** Andrea U Jakubowski
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $195,696
- **Award type:** 5
- **Project period:** 2023-07-01 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10873766

## Citation

> US National Institutes of Health, RePORTER application 10873766, Examining injectable buprenorphine implementation strategies in low-threshold and primary care settings (5K23DA052627-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10873766. Licensed CC0.

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