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Low barrier medication for opioid use disorder at a federally qualified health center: a retrospective cohort study.

Publication ,  Journal Article
Carter, J; Li, Z; Chen, H; Greiner, M; Bush, C; Bhattacharya, D; Poley, S; Sachdeva, N; Crowder, JC; Feigal, J
Published in: Addict Sci Clin Pract
November 5, 2022

BACKGROUND: Medication for opioid use disorder (MOUD) reduces mortality, but few patients access MOUD. At a Federally Qualified Health Center (FQHC), we implemented a low barrier model of MOUD, including same-day MOUD initiation and a harm reduction philosophy. OBJECTIVE: To investigate whether low barrier MOUD improved retention in care compared to traditional treatment. DESIGN AND PARTICIPANTS: Retrospective cohort study of patients with at least one visit seeking MOUD at the FQHC during a historical control period (3/1/2018-3/31/2019) and a low barrier intervention period (11/1/2019-7/31/2020). MAIN MEASURES: Primary outcomes were any MOUD prescription within 6 months of the index visit and 3- and 6-month retention in treatment without care gap, with care gap defined as 60 consecutive days without a visit or prescription. Secondary outcomes were all-cause hospitalization and emergency department visit within 6 months of the index visit. KEY RESULTS: Baseline characteristics were similar between the intervention (n = 113) and control (n = 90) groups, except the intervention group had higher rates of uninsured, public insurance and diabetes. Any MOUD prescription within 6 months of index visit was higher in the intervention group (97.3% vs 70%), with higher adjusted odds of MOUD prescription (OR = 4.01, 95% CI 2.08-7.71). Retention in care was similar between groups at 3 months (61.9% vs 60%, aOR = 1.06, 95% CI 0.78-1.44). At 6 months, a higher proportion of the intervention group was retained in care, but the difference was not statistically significant (53.1% vs 45.6%, aOR 1.27, 95% CI 0.93-1.73). There was no significant difference in adjusted odds of 6-month hospitalization or ED visit between groups. CONCLUSIONS: Low barrier MOUD engaged a higher risk population and did not result in any statistically significant difference in retention in care compared with a historical control. Future research should determine what interventions improve retention of patients engaged through low barrier care. Primary care clinics can implement low barrier treatment to make MOUD accessible to a broader population.

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Published In

Addict Sci Clin Pract

DOI

EISSN

1940-0640

Publication Date

November 5, 2022

Volume

17

Issue

1

Start / End Page

60

Location

England

Related Subject Headings

  • Retrospective Studies
  • Opioid-Related Disorders
  • Opiate Substitution Treatment
  • Humans
  • Harm Reduction
  • Emergency Service, Hospital
  • Buprenorphine
  • Analgesics, Opioid
  • 5203 Clinical and health psychology
  • 4206 Public health
 

Citation

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Carter, J., Li, Z., Chen, H., Greiner, M., Bush, C., Bhattacharya, D., … Feigal, J. (2022). Low barrier medication for opioid use disorder at a federally qualified health center: a retrospective cohort study. Addict Sci Clin Pract, 17(1), 60. https://doi.org/10.1186/s13722-022-00342-1
Carter, Jamie, Zhen Li, Hillary Chen, Melissa Greiner, Christopher Bush, Debanjan Bhattacharya, Stephanie Poley, Nidhi Sachdeva, Jane Carolyn Crowder, and Jacob Feigal. “Low barrier medication for opioid use disorder at a federally qualified health center: a retrospective cohort study.Addict Sci Clin Pract 17, no. 1 (November 5, 2022): 60. https://doi.org/10.1186/s13722-022-00342-1.
Carter J, Li Z, Chen H, Greiner M, Bush C, Bhattacharya D, et al. Low barrier medication for opioid use disorder at a federally qualified health center: a retrospective cohort study. Addict Sci Clin Pract. 2022 Nov 5;17(1):60.
Carter, Jamie, et al. “Low barrier medication for opioid use disorder at a federally qualified health center: a retrospective cohort study.Addict Sci Clin Pract, vol. 17, no. 1, Nov. 2022, p. 60. Pubmed, doi:10.1186/s13722-022-00342-1.
Carter J, Li Z, Chen H, Greiner M, Bush C, Bhattacharya D, Poley S, Sachdeva N, Crowder JC, Feigal J. Low barrier medication for opioid use disorder at a federally qualified health center: a retrospective cohort study. Addict Sci Clin Pract. 2022 Nov 5;17(1):60.
Journal cover image

Published In

Addict Sci Clin Pract

DOI

EISSN

1940-0640

Publication Date

November 5, 2022

Volume

17

Issue

1

Start / End Page

60

Location

England

Related Subject Headings

  • Retrospective Studies
  • Opioid-Related Disorders
  • Opiate Substitution Treatment
  • Humans
  • Harm Reduction
  • Emergency Service, Hospital
  • Buprenorphine
  • Analgesics, Opioid
  • 5203 Clinical and health psychology
  • 4206 Public health