More Individualized Care: Assessment and Recovery Through Engagement

INCLUSION CRITERIA Eligible patients must meet all 4 criteria: 1. ≥1 in person or virtual encounter in a primary care setting in the 365 days prior to the data extraction date (pull date); 2. Age ≥18 years at the pull date; 3. ≥1 PHQ-9 depression screening score of ≥10 within the 7 days prior to the pull date. 4. Evidence of potential OUD in the 365 days prior to and including the date of the qualifying PHQ-9 score. Any 1 of the following qualifies as evidence of potential OUD: 1. ≥1 active OUD ICD-10 diagnosis code in any setting except labs; 2. ≥1 prescription (orders or dispensed) for buprenorphine (oral formulations indicated for OUD, extended release injectable, and implant); 3. ≥1 procedure code for buprenorphine (oral formulations indicated for OUD, extended release injectable, and implant); 4. ≥1 ICD-10 codes for opioid overdose; 5. ≥1 OUD ICD-10 code, including remission, and prescription (orders or dispensed) or procedure code for injectable naltrexone. EXCLUSION CRITERIA Patients are ineligible who meet any of the criteria below: 1. The only indication of OUD or only PHQ available to determine eligibility came from data protected under 42 CFR Part 2; 2. The patient has already been randomized to the trial or was outreached in the pilot study (including outreach to the primary care provider only); 3. English interpreter required (per health system records). 4. Any one of the following conditions in the 2 years prior to and including the date of the qualifying PHQ: 1. Alzheimer's disease or dementia diagnosis, or medication to treat Alzheimer's or dementia. 2. Severe cognitive limitations. 5. Current active treatment for cancer with chemotherapy or radiation therapy in the past 3 months (not including non-melanoma skin cancers). 6. Previously requested to not participate in research studies at the health system; 7. Documentation of hospice care in the 2 years prior to and including the date of the qualifying PHQ score; 8. Patient is actively being outreached for (or is participating in) depression care management (Kaiser Permanente Washington only)