Evidence map›Paper›PMID 25738222›Full record

ArticleSubstance abuse2015

The Association Between Stimulant, Opioid, and Multiple Drug Use on Behavioral Health Care Utilization in a Safety-Net Health System.

Susan L Calcaterra, Angela Keniston, Joshua Blum, Tessa Crume, Ingrid A Binswanger

Open access · greenAbstract read
In one paragraph

Article in Substance abuse, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Susan L Calcaterraa Division of General Internal Medicine, Department of Medicine , University of Colorado School of Medicine , Aurora , Colorado , USA.
Angela Kenistonb Department of Medicine , Denver Health Medical Center , Denver , Colorado , USA.
Joshua Bluma Division of General Internal Medicine, Department of Medicine , University of Colorado School of Medicine , Aurora , Colorado , USA.
Tessa Crumec Department of Epidemiology, Colorado School of Public Health , University of Colorado School of Medicine , Aurora , Colorado , USA.
Ingrid A Binswangera Division of General Internal Medicine, Department of Medicine , University of Colorado School of Medicine , Aurora , Colorado , USA.
Denver Health Medical Center · USUniversity of Colorado Denver · USColorado School of Public Health · US

Funding

Overdose Risk Assessment, Counseling and Naloxone Prescription in Health CareR34DA035952 · NIDA · UNIVERSITY OF COLORADO DENVER · PI BINSWANGER, INGRID A · 2013 to 2015
$837k
Drug-Related Risk for Death After Release from PrisonR21DA031041 · NIDA · UNIVERSITY OF COLORADO DENVER · PI BINSWANGER, INGRID A · 2011 to 2012
$421k
HIV Risk Behavior in Drug-Involved Former InmatesR03DA029448 · NIDA · UNIVERSITY OF COLORADO DENVER · PI BINSWANGER, INGRID A · 2010 to 2011
$305k
NIDA NIH HHS R03 DA029448NIDA NIH HHS R03DA029448NIDA NIH HHS R21 DA031041NIDA NIH HHS R21DA031041NIDA NIH HHS R34 DA035952PHS HHS T32HP10006
6 · The paper itself

Abstract

backgroundPrior studies show an association between drug use and health care utilization. The relationship between specific drug type and emergent/urgent, inpatient, outpatient, and behavioral health care utilization has not been examined. We aimed to determine if multiple drug use was associated with increased utilization of behavioral health care.

methodsTo assess health care utilization, we conducted a retrospective cohort study of patients who accessed health care at a safety-net medical center and affiliated clinics. Using electronic health records, we categorized patients who used stimulants, opioids, or multiple drugs based on urine toxicology screening tests and/or International Classification of Diseases, 9th Revision (ICD-9). Remaining patients were categorized as patients without identified drug use. Health care utilization by drug use group and visit type was determined using a negative binomial regression model. Associations were reported as incidence rate ratios. Utilization was described by rates of health care-related visits for inpatient, emergent/urgent, outpatient, and behavioral health care among patients who used drugs, categorized by drug types, compared with patients without identified drug use.

resultsOf 95,198 index visits, 4.6% (n=4340) were by patients who used drugs. Opioid and multiple drug users had significantly higher rates of behavioral health care visits than patients without identified drug use (opioid incidence rate ratio [IRR]=7.2; 95% confidence interval [CI]: 3.8-13.8; multiple drug use IRR=5.6, 95% CI: 3.3-9.7). Patients who used stimulants were less likely to use behavioral health services (IRR=1.3, 95% CI: 0.9-2.0) when compared with opioid and multiple drug users, but were more likely to use inpatient (IRR=1.6, 95% CI: 1.4-1.8) and emergent/urgent care (IRR=1.4, 95% CI: 1.3-1.5) services as compared with patients without identified drug use.

conclusionsIntegrated medical and mental health care and drug treatment may reduce utilization of costly health care services and improve patient outcomes. How to capture and deliver primary care and behavioral health care to patients who use stimulants needs further investigation.

Indexed as

AdultAnalgesics, OpioidCase-Control StudiesCentral Nervous System StimulantsCommunity Health PlanningDrug UsersFemaleHumansMaleMental Health ServicesPatient Acceptance of Health CareRetrospective StudiesAnalgesics, OpioidCentral Nervous System StimulantsHealth caremultiple drug useopioidstimulantutilization

Identifiers

PMID25738222
PMCPMC4780338
OpenAlexW2046955703

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.