Objective: This study evaluated the association between medication for opioid use disorder (MOUD) and health care utilization over time among a sample of treatment-seeking individuals with opioid use disorder. In contrast to previous studies, this study used a novel measure of MOUD adherence, more comprehensive utilization data, and analyses that controlled for detailed individual and social determinants of health.
Methods: This study was a secondary analysis of a comparative effectiveness trial (N=570) of extended-release naltrexone versus buprenorphine-naloxone. The outcome of interest was usage of nonstudy acute care, inpatient and outpatient addiction services, and other outpatient services across 36 weeks of assessment. Adherence (percentage of days taking MOUD) was defined as low (<20%), medium (≥20% but <80%), or high (≥80%). A two-part model evaluated the probability of utilizing a resource and the quantity (utilization days) of the resource consumed. A time-varying approach was used to examine the effect of adherence in a given month on utilization in the same month, with analyses controlling for a wide range of person-level characteristics.
Results: Participants with high adherence (vs. low) were significantly less likely to use inpatient addiction (p<0.001) and acute care (p<0.001) services and significantly more likely to engage in outpatient addiction (p=0.045) and other outpatient (p=0.042) services.
Conclusions: These findings reinforce the understanding that greater MOUD adherence is associated with reduced usage of high-cost health services and increased usage of outpatient care. The results further suggest the need for enhanced access to MOUD and for interventions that improve adherence.
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http://dx.doi.org/10.1176/appi.ps.20220549 | DOI Listing |
Australas Psychiatry
January 2025
College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; Consortium of Australian-Academic Psychiatrists for Independent Policy Research and Analysis, Canberra, ACT, Australia; Department of Psychiatry, Monash University, Clayton, VIC, Australia.
Objective: Attention-deficit hyperactivity disorder (ADHD) medication prescriptions in Australia have grown sharply in recent years. We examined the association between online interest in ADHD and prescriptions.
Methods: Monthly Pharmaceutical Benefits Scheme (PBS) and Repatriation PBS (RPBS) Item Reports of ADHD prescriptions and Australian ADHD-related Google Trends (GT) data (2004-2023) were sourced.
Background: Women involved in the criminal legal system have elevated rates of opioid use disorder, which is treatable, and HIV, which is preventable with pre-exposure prophylaxis (PrEP). There are significant social and structural barriers to integrated delivery of PrEP and medications for opioid use disorder (MOUD), limiting women's ability to access these life-saving interventions. In a two parallel-arm randomized controlled trial, we are assessing an innovative eHealth delivery model that integrates PrEP with MOUD and is tailored to meet the specific needs of women involved in the criminal legal system.
View Article and Find Full Text PDFPLoS One
January 2025
Dept. of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, Massachusetts, United States of America.
Opioid dependence is defined by an aversive withdrawal syndrome upon drug cessation that can motivate continued drug-taking, development of opioid use disorder, and precipitate relapse. An understudied but common opioid withdrawal symptom is disrupted sleep, reported as both insomnia and daytime sleepiness. Despite the prevalence and severity of sleep disturbances during opioid withdrawal, there is a gap in our understanding of their interactions.
View Article and Find Full Text PDFBackground: Total shoulder arthroplasty frequently is performed in patients with a history of shoulder surgery. The purpose of this study was to evaluate clinical outcomes after primary shoulder arthroplasty in patients with a history of nonarthroplasty shoulder surgery, and whether certain modifiable risk factors (MRFs) were negatively associated with final outcome measures. The secondary purpose was to determine if costs or complications were higher in patients with prior shoulder surgery.
View Article and Find Full Text PDFInfant Ment Health J
January 2025
Canterbury Child Development Research Group, University of Canterbury, Christchurch, New Zealand.
Children born to mothers with opioid use disorder (OUD) are at increased risk of maltreatment and out-of-home care (OOHC) placement. This study examines the parent-child interaction quality and home environments of 92 New Zealand children with prenatal opioid exposure (OE) and 106 non-opioid-exposed (NE) children. Experiences for those in maternal care versus OOHC were of particular interest.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!