Evidence map›Paper›PMID 31604755›Full record

ArticleCanadian family physician Medecin de famille canadien2019

Opioid agonist therapy during residential treatment of opioid use disorder: Cohort study on access and outcomes.

Sheryl Spithoff, Christopher Meaney, Karen Urbanoski, Katy Harrington, Bill Que, Meldon Kahan, Pamela Leece, Vivian Shehadeh, Frank Sullivan

Abstract read
PubMed Full text at PMC
In one paragraph

Article in Canadian family physician Medecin de famille canadien, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 29% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
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  3. 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

9 authors at 7 institutions in 2 countries.

Sheryl SpithoffLecturer in the Department of Family and Community Medicine at the University of Toronto in Ontario, and a family physician and addiction physician in the Department of Family and Community Medicine at Women's College Hospital. sheryl.spithoff@wchospital.ca.
Christopher MeaneyAt the time of manuscript submission, was a biostatistician in the Department of Family and Community Medicine at the University of Toronto.
Karen UrbanoskiCanada Research Chair in Substance Use, Addictions and Health Services Research, a scientist at the Canadian Institute for Substance Use Research, and Assistant Professor in Public Health and Social Policy at the University of Victoria in British Columbia.
Katy HarringtonAt the time of writing, was a Family medicine resident with the South East Toronto Family Health Team and in the Department of Family and Community Medicine at the University of Toronto.
Bill QueIT Specialist, DATIS, Evaluation and Data Management, Provincial System Support Program at the Centre for Addiction and Mental Health in Toronto.
Meldon KahanAssociate Professor in the Department of Family and Community Medicine at the University of Toronto and Director of the Substance Use Service at Women's College Hospital.
Pamela LeecePublic health physician at Public Health Ontario in Toronto, and Assistant Professor in the Department of Family and Community Medicine and in the Dalla Lana School of Public Health at the University of Toronto.
Vivian ShehadehProject Leader at the Centre for Addiction and Mental Health at the time of submission.
Frank SullivanProfessor in the Department of Family and Community Medicine at the University of Toronto and Gordon F. Cheesbrough Research Chair in Family and Community Medicine at North York General Hospital.
Centre for Addiction and Mental Health · CACollege of Family Physicians of Canada · CABC Mental Health & Substance Use Services · CACommunity Hospital · USPublic Health Ontario · CAUniversity of Toronto · CAWomen's College Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine access to opioid agonist therapy (OAT) for those entering residential treatment for opioid use disorder; to report on treatment outcomes for those taking OAT and those not taking OAT; and to determine the association between OAT use and residential treatment completion.

designRetrospective cohort study.

settingOntario.

participantsPatients with opioid use disorder admitted to publicly funded residential treatment programs in the province of Ontario between January 1, 2013, and December 31, 2016.

main outcome measuresAccess to OAT during residential treatment using descriptive statistics. Treatment outcomes (ie, completed the program, voluntarily left early, involuntary discharged, and other) for the entire cohort and for the OAT and non-OAT groups using descriptive statistics. Association between OAT use at admission and treatment completion (a binary outcome) using bivariate and multivariate models.

resultsAmong an identified cohort of 1910 patients with opioid use disorder, 52.8% entered programs that permitted access to OAT. Overall, 56.8% of patients completed treatment, 23.3% voluntarily left early (eg, were no-shows, dropped out), 17.0% were involuntarily discharged, and 2.9% were discharged early for other reasons. Those taking OAT were as likely to complete treatment as those not taking OAT (53.9% vs 57.5%, respectively; adjusted odds ratio of 1.07, 95% CI 0.77 to 1.38).

conclusionThis study demonstrates 2 large gaps in care for patients with opioid use disorder. First, these patients have poor access to OAT-the first-line treatment of opioid use disorder-while in publicly funded residential treatment programs; and second, many are involuntarily discharged from treatment. Additionally, this study indicates that patients taking OAT have similar likelihood of completing residential treatment as those not taking OAT do. Limitations of this study are that it is based on observational data for patients who self-selected before admission to use OAT or not, and it is likely not all confounders were accounted for.

Indexed as

AdultAnalgesics, OpioidFemaleHumansMaleMethadoneOntarioOpiate Substitution TreatmentOpioid-Related DisordersResidential TreatmentRetention in CareRetrospective StudiesYoung AdultAnalgesics, OpioidMethadone

Identifiers

PMID31604755
PMCPMC6788647
OpenAlexW2980016827

What OpenQuestion holds

Textmetadata
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.