AI Article Synopsis
- The study investigates factors influencing the retention of patients on medications for opioid use disorder (MOUD) in rural areas, focusing on social determinants of health (SDoH).
- Findings suggest that living in disadvantaged areas and having longer driving times to clinics negatively impact the number of days patients stay on MOUD, while using telehealth positively correlates with increased retention.
- The research highlights potential solutions like improving transportation and internet access to enhance treatment adherence for opioid use disorder in rural communities.
Article Abstract
Objectives: Factors associated with treatment retention on medications for opioid use disorder (MOUD) in rural settings are poorly understood. This study examines associations between social determinants of health (SDoH) and MOUD retention among patients with opioid use disorder (OUD) in rural primary care settings.
Methods: We analyzed patient electronic health records from 6 rural clinics. Participants (N = 575) were adult patients with OUD and had any prescription for MOUD from October 2019 to April 2020. MOUD retention was measured by MOUD days and continuity defined as continuous 180 MOUD days with no more than a 7-day gap. Mixed-effect regressions assessed associations between the outcomes and SDoH (Medicaid insurance, social deprivation index [SDI], driving time from home to the clinic), telehealth use, and other covariates.
Results: Mean patient MOUD days were 127 days (SD = 50.7 days). Living in more disadvantaged areas (based on SDI) (adjusted relative risk [aRR]: 0.98; 95% confidence interval [CI], 0.98-0.99) and having more than an hour (compared with an hour or less) driving time from home to clinic (aRR: 0.95; 95% CI, 0.93-0.97) were associated with fewer MOUD days. Using telehealth was associated with more MOUD days (aRR: 1.23; 95% CI, 1.21-1.26). In this cohort, 21.7% of the participants were retained on MOUD for at least 180 days. SDoH and use of telehealth were not associated with having continuity of MOUD.
Conclusions: Addressing SDoH (eg, SDI) and providing telehealth (eg, improvements in public transportation, internet access) may improve MOUD days in rural settings.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11150102 | PMC |
| http://dx.doi.org/10.1097/ADM.0000000000001274 | DOI Listing |
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