Medication for opioid use disorder treatment and specialty outpatient substance use treatment outcomes: Differences in retention and completion among opioid-related discharges in 2016
Medication for opioid use disorder treatment and specialty outpatient substance use treatment outcomes: Differences in retention and completion among opioid-related discharges in 2016
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DOI：
10.1016/j.jsat.2020.108028
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发表时间：
2020-07-01
影响因子：
3.9
通讯作者：
Mauro, Pia M.
中科院分区：
文献类型：
--
作者：
Askari, Melanie S.;Martins, Silvia S.;Mauro, Pia M.
获得阿片类药物治疗是一项公共卫生优先事项，旨在改善阿片类药物使用治疗结果。然而，在许多州，医疗补助并不包括所有形式的mod，尤其是美沙酮。我们检查了阿片类药物使用障碍（mod）计划的药物治疗与药物使用治疗出院原因（例如，完成治疗，退出治疗）以及治疗保留（即住院时间）之间的关系，并估计这些关系是否被国家医疗补助美沙酮覆盖范围所改变。2016年出院治疗事件数据集（ted - d）的数据包括来自47个州的152196次阿片类药物相关治疗事件，使用相对风险回归和州聚类。mod患者在> 180天（aRR: 1.60, 95% CI: 1.29, 1.99）和> 365天（aRR: 2.64, 95% CI: 2.00, 3.49）的治疗保留率较高，但治疗完成率较低（aRR: 0.46, 95% CI: 0.38, 0.57）。没有证据表明国家医疗补助计划的美沙酮覆盖范围改变了这些关系。仅关注治疗完成可能会模糊与更长时间的mod治疗保持相关的健康益处。
Opioid medication treatment access is a public health priority aimed to improve opioid use treatment outcomes. However, Medicaid does not cover all forms of MOUD, particularly methadone, in many states. We examined associations between medication for opioid use disorder (MOUD) plans and substance use treatment discharge reason (e.g., completed treatment, dropped out of treatment) as well as treatment retention (i.e., length of stay), and estimated whether these relationships were modified by state Medicaid methadone coverage. Data from the 2016 Treatment Episode Data Set for Discharges (TEDS-D) included 152,196 opioid-related treatment episodes from 47 states using relative risk regression with state clustering. Discharges involving MOUD had higher treatment retention for > 180 days (aRR: 1.60, 95% CI: 1.29, 1.99) and > 365 days (aRR: 2.64, 95% CI: 2.00, 3.49) but lower treatment completion (aRR: 0.46, 95% CI: 0.38, 0.57). There was no evidence that state Medicaid methadone coverage modified any of these relationships. Focusing on treatment completion alone may obscure health benefits associated with longer MOUD treatment retention.