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Optimizing Patient Centered-Care: A Pragmatic Randomized Control Trial Comparing Models of Care in the Management of Prescription Opioid Misuse (OPTIMA)

The OPTIMA study is the first national study conducted across all 4 CRISM nodes. It is a pragmatic randomized trial to compare and evaluate two existing treatments for prescription opioid addiction: methadone and buprenorphine/naloxone.

OPTIMA addresses the use of prescription opioid medications (i.e. oxycodone, hydromorphone) which has dramatically increased in recent years in Canada, leading to a rise in opioid misuse and related harms such as hospitalization and deaths due to overdose. Thus, the prevention and treatment of opioid addiction has become an urgent public health priority, which requires an evidence-based response that best reflects the needs of patients and their families.

Opioid substitution treatment is widely used to treat prescription opioid addiction. The OPTIMA study compares and evaluates two such treatments: methadone, which is the current standard of care in Canada, and buprenorphine/naloxone, the therapy of choice in the United States. In order to improve patient care, the study addresses real-world treatment conditions, including patient preference for short-term vs. long-term treatment, strict regulations for methadone dosing (i.e. dispensed daily at a pharmacy) vs. flexible take-home dosing for buprenorphine/naloxone, and treatment adherence, among others. The OPTIMA study is designed with the intention to support patient-provider shared decision-making processes in order to increase the number of patients that stay in treatment and improve the success rates of patient-centered approaches. The comparison of the effectiveness of the two treatment models in reducing prescription opioid use will generate practice-based evidence that will be used to inform patient care and improve overall health outcomes. For more information, please see this OPTIMA infographic.

The Ontario site of the OPTIMA study is led by Dr. Bernard Le Foll, the OPTIMA regional principal investigator (Ontario), Clinician-Scientist, and the head of the Translational Addiction Research Lab and the Alcohol Research and Treatment Clinics at CAMH.

The National OPTIMA Study clinical Lead is Dr. Didier Jutras-Aswad.

Study Contact:

National OPTIMA Study Coordinator                                  Regional OPTIMA Study Coordinator
Jill Fikowski, MPH                                                                    Jose Trigo, PhD                                             
Telephone: 604-682-2344 x66871                                       Telephone: 416-535-8501 x36773

OPTIMA is currently in the recruitment stage (see recruitment materials for more information). 

For a 2018 update, please see this infographic.

Voice Recorder Image.2.PNGListen to an interview with OPTIMA's regional PI, Dr. Bernard Le Foll.