Understanding Early Discontinuation of Medications for Opioid Use Disorder in Primary Care
Author Information
Author(s): Rebecca Harris, Matthew Kearney, Shimrit Keddem, Tara Calderbank, Liza Tomczuk, Justin Clapp, Jeanmarie Perrone, Henry R. Kranzler, Judith A. Long, David S. Mandell
Primary Institution: Perelman School of Medicine, University of Pennsylvania
Hypothesis
How do primary care clinic structures influence early discontinuation of medications for opioid use disorder (MOUD)?
Conclusion
Improving appointment access, implementing hybrid care delivery models, and fostering interdisciplinary collaboration could help primary care clinics better support patients in the crucial early phase of MOUD treatment.
Supporting Evidence
- Primary care clinic structures and operations may influence early MOUD discontinuation.
- Flexible scheduling can improve early MOUD retention but must be balanced with clinic efficiency.
- Multidisciplinary teams can improve retention but require additional resources.
- Addressing comorbid pain and polydrug use early in the treatment process can help prevent MOUD discontinuation.
Takeaway
This study looked at how the way primary care clinics are set up can affect whether people stick with their treatment for opioid use disorder. Making it easier for patients to get appointments and work together with different types of healthcare providers can help them stay in treatment.
Methodology
The study conducted semi-structured interviews with patients, primary care providers (PCPs), and clinic administrators to explore factors influencing early MOUD discontinuation.
Potential Biases
Potential participation bias and recall bias may affect the findings.
Limitations
The study focused on clinic-level factors and may not generalize to other settings, particularly rural clinics or those with different funding structures or patient populations.
Participant Demographics
{"patients":{"total":12,"gender":{"male":8,"female":4},"race":{"Black":4,"White":7,"Other":1},"ethnicity":{"Hispanic/Latinx":2,"Non-Hispanic/Latinx":10},"median_age":35,"substance_use_history":{"prescription_opioids":8,"heroin":9,"fentanyl":9,"benzodiazepines":9,"cocaine":6,"methamphetamines":5}},"clinicians":{"total":12,"gender":{"male":5,"female":7},"race":{"Black":1,"White":9,"Asian":2}},"administrators":{"total":6,"gender":{"male":3,"female":3},"race":{"non-White":1,"White":5}}}
Digital Object Identifier (DOI)
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