A cohort study evaluating the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment (OAT) across Ontario, Canada, using administrative health data
Abstract Background Due to the high prevalence of mental disorders among people with opioid use disorder, the objective of this study was to determine the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatmen...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-07-01
|
| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12954-020-00396-x |
| _version_ | 1819194805398274048 |
|---|---|
| author | Kristen A. Morin Joseph K. Eibl Graham Gauthier Brian Rush Christopher Mushquash Nancy E. Lightfoot David C. Marsh |
| author_facet | Kristen A. Morin Joseph K. Eibl Graham Gauthier Brian Rush Christopher Mushquash Nancy E. Lightfoot David C. Marsh |
| author_sort | Kristen A. Morin |
| collection | DOAJ |
| description | Abstract Background Due to the high prevalence of mental disorders among people with opioid use disorder, the objective of this study was to determine the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment in Ontario, Canada. Methods We conducted a retrospective cohort study of patients enrolled in opioid agonist treatment between January 1, 2011, and December 31, 2015. Patients were stratified into two groups: those diagnosed with concurrent mental disorders and opioid use disorder and those with opioid use disorder only, using data from the Ontario Health Insurance Plan Database, Ontario Drug Benefit Plan Database. The primary outcome studied was all-cause mortality using data from the Registered Persons Database. Emergency department visits from the National Ambulatory Care Database, hospitalizations Discharge Abstract Database, and continuous retention in treatment, defined as 1 year of uninterrupted opioid agonist treatment using data from the Ontario Drug Benefit Plan Database were measured as secondary outcomes. Encrypted patient identifiers were used to link information across databases. Results We identified 55,924 individuals enrolled in opioid agonist treatment, and 87% had a concurrent mental disorder diagnosis during this period. We observed that having a mental disorder was associated with an increased likelihood of all-cause mortality (odds ratio (OR) 1.4; 95% confidence interval (CI) 1.2–1.5). For patients diagnosed with mental disorders, the estimated rate of ED visits per year was 2.25 times higher and estimated rate of hospitalization per year was 1.67 times higher than for patients with no mental disorders. However, there was no association between having a diagnosis of a mental disorder and 1-year treatment retention in OAT-adjusted hazard ratio (HR) = 1.0; 95% CI 0.9 to 1.1. Conclusion Our findings highlight the consequences of the high prevalence of mental disorders for individuals with opioid use disorder in Ontario, Canada. |
| first_indexed | 2024-12-23T02:02:42Z |
| format | Article |
| id | doaj.art-c56f71e25073470b93cf139fcf432b3c |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-12-23T02:02:42Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-c56f71e25073470b93cf139fcf432b3c2022-12-21T18:03:57ZengBMCHarm Reduction Journal1477-75172020-07-0117111310.1186/s12954-020-00396-xA cohort study evaluating the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment (OAT) across Ontario, Canada, using administrative health dataKristen A. Morin0Joseph K. Eibl1Graham Gauthier2Brian Rush3Christopher Mushquash4Nancy E. Lightfoot5David C. Marsh6Northern Ontario, School of MedicineHealth Sciences North Research InstituteNorthern Ontario, School of MedicineCentre for Addiction and Mental HealthNorthern Ontario, School of MedicineLaurentian UniversityNorthern Ontario, School of MedicineAbstract Background Due to the high prevalence of mental disorders among people with opioid use disorder, the objective of this study was to determine the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment in Ontario, Canada. Methods We conducted a retrospective cohort study of patients enrolled in opioid agonist treatment between January 1, 2011, and December 31, 2015. Patients were stratified into two groups: those diagnosed with concurrent mental disorders and opioid use disorder and those with opioid use disorder only, using data from the Ontario Health Insurance Plan Database, Ontario Drug Benefit Plan Database. The primary outcome studied was all-cause mortality using data from the Registered Persons Database. Emergency department visits from the National Ambulatory Care Database, hospitalizations Discharge Abstract Database, and continuous retention in treatment, defined as 1 year of uninterrupted opioid agonist treatment using data from the Ontario Drug Benefit Plan Database were measured as secondary outcomes. Encrypted patient identifiers were used to link information across databases. Results We identified 55,924 individuals enrolled in opioid agonist treatment, and 87% had a concurrent mental disorder diagnosis during this period. We observed that having a mental disorder was associated with an increased likelihood of all-cause mortality (odds ratio (OR) 1.4; 95% confidence interval (CI) 1.2–1.5). For patients diagnosed with mental disorders, the estimated rate of ED visits per year was 2.25 times higher and estimated rate of hospitalization per year was 1.67 times higher than for patients with no mental disorders. However, there was no association between having a diagnosis of a mental disorder and 1-year treatment retention in OAT-adjusted hazard ratio (HR) = 1.0; 95% CI 0.9 to 1.1. Conclusion Our findings highlight the consequences of the high prevalence of mental disorders for individuals with opioid use disorder in Ontario, Canada.http://link.springer.com/article/10.1186/s12954-020-00396-xOpioid use disorderOpioid agonist treatmentMental disorders |
| spellingShingle | Kristen A. Morin Joseph K. Eibl Graham Gauthier Brian Rush Christopher Mushquash Nancy E. Lightfoot David C. Marsh A cohort study evaluating the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment (OAT) across Ontario, Canada, using administrative health data Harm Reduction Journal Opioid use disorder Opioid agonist treatment Mental disorders |
| title | A cohort study evaluating the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment (OAT) across Ontario, Canada, using administrative health data |
| title_full | A cohort study evaluating the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment (OAT) across Ontario, Canada, using administrative health data |
| title_fullStr | A cohort study evaluating the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment (OAT) across Ontario, Canada, using administrative health data |
| title_full_unstemmed | A cohort study evaluating the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment (OAT) across Ontario, Canada, using administrative health data |
| title_short | A cohort study evaluating the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment (OAT) across Ontario, Canada, using administrative health data |
| title_sort | cohort study evaluating the association between concurrent mental disorders mortality morbidity and continuous treatment retention for patients in opioid agonist treatment oat across ontario canada using administrative health data |
| topic | Opioid use disorder Opioid agonist treatment Mental disorders |
| url | http://link.springer.com/article/10.1186/s12954-020-00396-x |
| work_keys_str_mv | AT kristenamorin acohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT josephkeibl acohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT grahamgauthier acohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT brianrush acohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT christophermushquash acohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT nancyelightfoot acohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT davidcmarsh acohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT kristenamorin cohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT josephkeibl cohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT grahamgauthier cohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT brianrush cohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT christophermushquash cohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT nancyelightfoot cohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata AT davidcmarsh cohortstudyevaluatingtheassociationbetweenconcurrentmentaldisordersmortalitymorbidityandcontinuoustreatmentretentionforpatientsinopioidagonisttreatmentoatacrossontariocanadausingadministrativehealthdata |