In a study conducted in collaboration with Columbia University, Rutgers researchers recently determined that patients who are being treated for an opioid use disorder will see more success in their treatment if they participate in more of outpatient visits, according to a article from Rutgers today.
Stephen Crystal, co-author of the study and director of the Center for Health Services Research at the Rutgers Institute for Health, Health Care Policy and Aging Research, said the goal of the study was to look at the factors that drive patients to discontinue their treatment.
Crystal said the researchers’ goal was to better guide clinicians, as the effectiveness of treatment for opioid use disorder has recently been limited due to the frequency of patients opting to quit early. of their treatment.
The researchers also aimed to determine whether the engagement performance measure, which reflects how often patients show up for their treatment appointments, is necessary to examine opioid medication retention in long-term treatment. , said Crystal.
“An important finding was that patients who failed to show up for at least two visits in the first 34 days of treatment had almost no chance of reaching the six-month mark,” he said. “Although a few patients re-engaged in care after this type of poor start, this was very rare, with only 2.9% of these patients reaching the 6-month mark and only one in 10,000 reaching the two-year mark. . .”
The performance measure specifically indicates whether individuals attended two outpatient visits within a 34-day period after starting treatment, he said. Those who participated have the highest chance of drug retention, making engagement performance measurement necessary for treatment review.
He said the research in the study used patient data from 19,487 people from 2011 to 2019. These patients started treatment during this time and had their treatment retention reviewed for a period of around two years. .
The patients were treated with buprenorphine, a drug commonly used to treat opioid use disorder that reduces the possibility of overdose by two-thirds to four-fifths as patients continue treatment, Crystal said. .
He also said six months of treatment is considered the minimum for people being treated for an opioid use disorder. Less time is insufficient for patients to be properly treated.
“Successful induction into treatment requires good professional support due to the strong psychological reinforcing effects of street opioids and the presence of strong cravings for these drugs,” Crystal said. “Even though buprenorphine strongly reduces these cravings, many people lack sufficient motivation to avoid relapses and professional support in the process is vital.”
Crystal said that while the researchers weren’t surprised to find that initial engagement is predictive of retention, they didn’t expect exactly how predictive the performance measure actually was, because only a small number of patients who did not reach the measure received long-term treatment.
He also said another unexpected finding in the study’s research was that people who received buprenorphine without a prescription were twice as likely to hit the six-month opioid medication retention mark.
“This (finding) is a phenomenon that has not received sufficient attention, and which we believe may suggest that law enforcement concerns about the risks of diversion of prescribed buprenorphine are misplaced, and in effect that ‘informal’ treatment with non-prescribed buprenorphine is in fact likely to be beneficial,” he said.
Additionally, Crystal said other factors could also contribute to treatment success, including mental health issues.
Crystal said the results of this study have major implications for other disorders because adherence to treatment is the biggest limiting factor in treatment effectiveness.
He also said researchers are currently studying the effectiveness of current treatment for opioid use in populations at risk for opioid use disorders, including people with disabilities who receive Medicaid and people who were released from prison.
“The goal of this global research program is to help health systems transform their approach to helping people with opioid use disorders by improving often ineffective approaches that have not yet been successful. reducing the number of overdoses and implementing evidence-based strategies that can improve outcomes and support a national commitment to end the opioid overdose epidemic,” he said.
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