Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes
Objectives: Medication for opioid use disorder (MOUD) has gained significant momentum as an evidence-based intervention for treating opioid use disorder (OUD). The purpose of this study was to characterize MOUD initiations for buprenorphine and extended release (ER) naltrexone across all care sites...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-12-01
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| Series: | Drug and Alcohol Dependence Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772724622000890 |
| _version_ | 1811292121760530432 |
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| author | Brian P. O'Rourke Tory H. Hogan Julie Teater Martin Fried Margaret Williams Alison Miller Aaron D. Clark Phuong Huynh Emily Kauffman Jennifer L. Hefner |
| author_facet | Brian P. O'Rourke Tory H. Hogan Julie Teater Martin Fried Margaret Williams Alison Miller Aaron D. Clark Phuong Huynh Emily Kauffman Jennifer L. Hefner |
| author_sort | Brian P. O'Rourke |
| collection | DOAJ |
| description | Objectives: Medication for opioid use disorder (MOUD) has gained significant momentum as an evidence-based intervention for treating opioid use disorder (OUD). The purpose of this study was to characterize MOUD initiations for buprenorphine and extended release (ER) naltrexone across all care sites at a major health system in the Midwest and determine whether MOUD initiation was associated with inpatient outcomes. Methods: The study population comprised patients with OUD in the health system between 2018 and 2021. First, we described characteristics of all MOUD initiations for the study population within the health system. Second, we compared inpatient length of stay (LOS) and unplanned readmission rates between patients prescribed MOUD and patients not prescribed MOUD, including a pre-post comparison of patients prescribed MOUD before versus after initiation. Results: The 3,831 patients receiving MOUD were mostly white, non-Hispanic and generally received buprenorphine over ER naltrexone. 65.5% of most recent initiations occurred in an inpatient setting. Compared to those not prescribed MOUD, inpatient encounters where patients received MOUD on or before the admission date were significantly less likely to be unplanned readmissions (13% vs. 20%, p < 0.001) and their LOS was 0.14 days shorter (p = 0.278). Among patients prescribed MOUD, there was a significant reduction in the readmission rate after initiation compared to before (13% vs. 22%, p < 0.001). Conclusions: This study is the first to examine MOUD initiations for thousands of patients across multiple care sites in a health system, finding that receiving MOUD is associated with clinically meaningful reductions in readmission rates. |
| first_indexed | 2024-04-13T04:40:30Z |
| format | Article |
| id | doaj.art-60278f7b9655407ba5ab6ce2bffc034c |
| institution | Directory Open Access Journal |
| issn | 2772-7246 |
| language | English |
| last_indexed | 2024-04-13T04:40:30Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Drug and Alcohol Dependence Reports |
| spelling | doaj.art-60278f7b9655407ba5ab6ce2bffc034c2022-12-22T03:02:00ZengElsevierDrug and Alcohol Dependence Reports2772-72462022-12-015100114Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomesBrian P. O'Rourke0Tory H. Hogan1Julie Teater2Martin Fried3Margaret Williams4Alison Miller5Aaron D. Clark6Phuong Huynh7Emily Kauffman8Jennifer L. Hefner9The Division of Health Services Management and Policy, College of Public Health, The Ohio State University, 1841 Neil Ave Rm 250, Columbus, OH 43210, USA; Corresponding author.The Division of Health Services Management and Policy, College of Public Health, The Ohio State University, 1841 Neil Ave Rm 250, Columbus, OH 43210, USAThe Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USAThe Division of General Internal Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USAThe Division of Hospital Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USANeurological Institute, The Ohio State University Wexner Medical Center, 410 W. 10th Ave, Columbus, OH 43210, USAThe Department of Family and Community Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USAThe Department of Family and Community Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USAThe Division of General Internal Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USA; Department of Emergency Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USAThe Division of Health Services Management and Policy, College of Public Health, The Ohio State University, 1841 Neil Ave Rm 250, Columbus, OH 43210, USA; The Department of Family and Community Medicine, College of Medicine, The Ohio State University, 370 W. 9th Avenue, Columbus, OH 43210, USAObjectives: Medication for opioid use disorder (MOUD) has gained significant momentum as an evidence-based intervention for treating opioid use disorder (OUD). The purpose of this study was to characterize MOUD initiations for buprenorphine and extended release (ER) naltrexone across all care sites at a major health system in the Midwest and determine whether MOUD initiation was associated with inpatient outcomes. Methods: The study population comprised patients with OUD in the health system between 2018 and 2021. First, we described characteristics of all MOUD initiations for the study population within the health system. Second, we compared inpatient length of stay (LOS) and unplanned readmission rates between patients prescribed MOUD and patients not prescribed MOUD, including a pre-post comparison of patients prescribed MOUD before versus after initiation. Results: The 3,831 patients receiving MOUD were mostly white, non-Hispanic and generally received buprenorphine over ER naltrexone. 65.5% of most recent initiations occurred in an inpatient setting. Compared to those not prescribed MOUD, inpatient encounters where patients received MOUD on or before the admission date were significantly less likely to be unplanned readmissions (13% vs. 20%, p < 0.001) and their LOS was 0.14 days shorter (p = 0.278). Among patients prescribed MOUD, there was a significant reduction in the readmission rate after initiation compared to before (13% vs. 22%, p < 0.001). Conclusions: This study is the first to examine MOUD initiations for thousands of patients across multiple care sites in a health system, finding that receiving MOUD is associated with clinically meaningful reductions in readmission rates.http://www.sciencedirect.com/science/article/pii/S2772724622000890Medication for opioid use disorderCare coordinationBuprenorphineNaltrexoneOpioid treatment programs |
| spellingShingle | Brian P. O'Rourke Tory H. Hogan Julie Teater Martin Fried Margaret Williams Alison Miller Aaron D. Clark Phuong Huynh Emily Kauffman Jennifer L. Hefner Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes Drug and Alcohol Dependence Reports Medication for opioid use disorder Care coordination Buprenorphine Naltrexone Opioid treatment programs |
| title | Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes |
| title_full | Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes |
| title_fullStr | Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes |
| title_full_unstemmed | Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes |
| title_short | Initiation of medication for opioid use disorder across a health system: A retrospective analysis of patient characteristics and inpatient outcomes |
| title_sort | initiation of medication for opioid use disorder across a health system a retrospective analysis of patient characteristics and inpatient outcomes |
| topic | Medication for opioid use disorder Care coordination Buprenorphine Naltrexone Opioid treatment programs |
| url | http://www.sciencedirect.com/science/article/pii/S2772724622000890 |
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