Research agenda evaluating measurement-based care for opioid use disorder among patients with co-occurring depressive disorders [opinion].

Buprenorphine and other medication treatments for opioid use disorder (OUD) in general medical settings are effective in preventing drug overdoses related to opioid use, although treatment retention is often challenging. Real-world data indicate high medication discontinuation rates at 6 months or greater following treatment initiation, partially indicative of a common failure to optimize medication dosing to minimize side effects, maximize therapeutic effects, and sustain treatment engagement and adherence. These barriers hinder the achievement of optimal clinical outcomes in managing conditions like OUD, which is often a chronic relapsing condition and frequently associated with mood disorders. Measurement-based care (MBC) may be defined as an evidence-based healthcare approach in which systematic outcome monitoring of disease severity and symptomatology over time yields actionable feedback to providers to guide their clinical decision-making on how to customize medication dosing promptly to improve patients’ treatment outcomes.

This opinion piece describes a proposed research agenda evaluating measurement-based care for opioid use disorder among patients with co-occurring depressive disorders that emphasizes pragmatic, multisite effectiveness-implementation trials to operationalize MBC in real-world, community-based, and primary care settings. The National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) is positioned as a potential platform for advancing this agenda, leveraging its experience in bridging research and practice.