Retention of opioid agonist treatment prescribers across New South Wales, Australia, 2001-2018: Implications for treatment systems and potential impact on client outcomes.
Retention of opioid agonist treatment prescribers across New South Wales, Australia, 2001-2018: Implications for treatment systems and potential impact on client outcomes.
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保留澳大利亚新南威尔士州的阿片类药物治疗处方者，2001- 2018年：对治疗系统的影响以及对客户结果的潜在影响。
DOI：
10.1016/j.drugalcdep.2020.108464
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发表时间：
2021-02-01
影响因子：
4.2
通讯作者：
Degenhardt L
中科院分区：
文献类型：
--
作者：
Jones NR;Nielsen S;Farrell M;Ali R;Gill A;Larney S;Degenhardt L
There has been much research on the efficacy and effectiveness of opioid agonist treatment (OAT), but less on its implementation and sustainability. A challenge internationally has been recruiting and retaining prescribers. This paper aims to characterise the prescribers in terms of OAT prescribing behaviours. Retrospective cohort study in New South Wales, Australia. Participants were 2,199 OAT prescribers between 1st August 2001–19th September 2018.We examined trends in initiation and cessation of OAT prescribers. Adjusted hazard ratios were calculated to estimate prescriber retention, adjusting for year of initiation, practice type, client load and treatment prescribed. The rate of prescribers ceasing OAT prescribing has been increasing over time: a prescriber who initiated between 2016–2017 had over four times the risk of cessation compared with one who initiated before 2001, AHR: 4.77; [3.67–6.21]. The highest prescriber cessation rate was in prescribers who had prescribed for shorter time periods. The annual percentage of prescribers who ceased prescribing among those who prescribed for ≤5 years increased from 3% in 2001 to 20% in 2017. By 2017 more prescribers were discontinuing prescribing than new prescribers were starting. Approximately 87% (n=25,167) of OAT clients were under the care of 20% of OAT prescribers (n=202); half had been prescribing OAT for 17+ years. OAT prescribing is increasingly concentrated in a small group of mature prescribers, and new prescribers are not being retained. There is a need to identify and respond to the reasons that contribute to newer prescribers to cease prescribing and put in place strategies to increase retention and broaden the base of doctors involved in such prescribing.
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影响因子：
2.9
作者：
Larney S;Hickman M;Fiellin DA;Dobbins T;Nielsen S;Jones NR;Mattick RP;Ali R;Degenhardt L
通讯作者：
Degenhardt L
DOI：
10.1136/bmj.e5945
发表时间：
2012-10-03
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
MacArthur GJ;Minozzi S;Martin N;Vickerman P;Deren S;Bruneau J;Degenhardt L;Hickman M
通讯作者：
Hickman M
影响因子：
2.2
作者：
Matheson, C;Bond, CM;Hickey, F
通讯作者：
Hickey, F
影响因子：
6
作者：
Matheson, C;Pitcairn, J;Ryan, M
通讯作者：
Ryan, M
DOI：
10.1136/bmj.c3172
发表时间：
2010-07-01
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Kimber J;Copeland L;Hickman M;Macleod J;McKenzie J;De Angelis D;Robertson JR
通讯作者：
Robertson JR