Todd Olmstead will serve as co-principal investigator and co-investigator on two NIH grants totaling $15M
With colleagues from the University of Massachusetts, Todd Olmstead from The University of Texas at Austin LBJ School of Public Affairs will serve as a co-principal investigator on a four-year, $12.3 million National Institute of Mental Health grant studying recovery in individuals with co-occurring opioid use disorder (OUD) and mental health needs. Olmstead will examine the cost and cost-effectiveness of a treatment program, called Maintaining Independence and Sobriety through Systems Integration, Outreach and Networking, or MISSION.
Opioid use disorder is an epidemic in the United States, affecting over 2.1 million people (NIH). The Centers for Disease Control reports from 2018 to 2019, there were significant changes in opioid-involved death rates:
- Opioid-involved death rates increased by over 6%.
- Prescription opioid-involved death rates decreased by nearly 7%.
- Heroin-involved death rates decreased by over 6%.
- Synthetic opioid-involved death rates (excluding methadone) increased by over 15%.
In a national study, Penn State College of Medicine researchers also found young people ages 12‑25 with certain mental health conditions and histories of substance misuse may have an increased risk of being diagnosed with an OUD.
"For years, MISSION has been shown to be effective but costly. This study will finally give us an opportunity to look under the hood and see which of MISSION’s components are doing the heavy lifting, in hopes of designing a more cost-effective model for the future." – Todd Olmstead
MISSION’s treatment program comprises three components: critical time intervention, a form of assertive community therapy that connects clients to housing, employment and other support services; dual recovery therapy, which integrates mental health and substance use group therapy; and peer support, which offers support for people in recovery by people with lived experience. Research shows MISSION to be both effective in individuals with addiction and mental health needs and resource intensive.
The grant, which will enroll 1,000 patients from 11 sites across Massachusetts, aims to assess the effectiveness and cost-effectiveness of overall MISSION compared to its individual components, when combined with medication-assisted treatment. Researchers hope to use their findings to create a treatment with MISSION’s most cost-effective components.
Partners in the study include UMass Chan, UMass Lowell, Harvard University and Yale University. The study also includes collaborations with the Massachusetts Department of Public Health and MassHealth, the state’s Medicaid program.
Second, Olmstead will serve as a co-investigator on a five-year, $3.5 million National Heart, Lung, and Blood Institute grant studying smoking cessation pharmacotherapy (SCP) among hospitalized smokers with cardiopulmonary conditions.
Pharmacotherapy treatments aim to reduce symptoms of nicotine withdrawal, thereby making it easier to stop using cigarettes.
Tobacco use remains the leading cause of death in the United States and contributes to more than 7 million hospitalizations annually. Despite professional guidelines recommending SCP, only 22% of patients are ever prescribed smoking cessation medications and only 1% are prescribed guideline-concordant SCP.
This study will enroll 424 hospital inpatients at Baystate Medical Center and deploy a nurse-practitioner led, hospital-based tobacco treatment team to prescribe effective medications, counsel patients on how to use them properly, and manage a text messaging system with the goal of improving medication use and smoking cessation. Olmstead will examine the cost-effectiveness and economic sustainability of the novel SCP intervention.
Olmstead said, "I'm excited to be a part of both of these studies. If the SCP model is successful, more hospitals will be able to capture the “teachable moment” of hospitalization to help smokers quit permanently.”
Olmstead is an associate professor of public affairs at the LBJ School, who teaches courses on empirical methods, management science and health economics, including methods for economic evaluation of local health care programs. He conducts economic evaluations of a wide variety of health care programs including an Austin-area residential mental health care facility, peer recovery support in substance use treatment and an Austin colorectal cancer screening initiative.