Evidence map›Paper›PMID 33360851›Full record

ArticleDrug and alcohol dependence2021

Retention of opioid agonist treatment prescribers across New South Wales, Australia, 2001-2018: Implications for treatment systems and potential impact on client outcomes.

Nicola R Jones, Suzanne Nielsen, Michael Farrell, Robert Ali, Anthony Gill, Sarah Larney, Louisa Degenhardt

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug and alcohol dependence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.8field-weighted citation impact, top 13% 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

10 citing papers in PubMed, 25 citations in OpenAlex.

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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

7 authors at 4 institutions in 2 countries.

Nicola R JonesNational Drug and Alcohol Research Centre, University of NSW, Sydney NSW 2052, Australia. Electronic address: nicola.jones@unsw.edu.au.
Suzanne NielsenMonash Addiction Research Centre and Eastern Health Clinical School, Monash University, Melbourne, Australia. Electronic address: suzanne.nielsen@monash.edu.au.
Michael FarrellNational Drug and Alcohol Research Centre, University of NSW, Sydney NSW 2052, Australia. Electronic address: michael.farrell@unsw.edu.au.
Robert AliNational Drug and Alcohol Research Centre, University of NSW, Sydney NSW 2052, Australia; School of Medicine, The University of Adelaide, Australia. Electronic address: robert.ali@adelaide.edu.au.
Anthony GillNSW Ministry of Health, Level 6, 100 Christie St, St Leonards NSW 2065, Australia. Electronic address: anthony.gill@svha.org.au.
Sarah LarneyNational Drug and Alcohol Research Centre, University of NSW, Sydney NSW 2052, Australia; Department of Family Medicine and Emergency Medicine, Université de Montréal and Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Canada. Electronic address: sarah.larney@umontreal.ca.
Louisa DegenhardtNational Drug and Alcohol Research Centre, University of NSW, Sydney NSW 2052, Australia. Electronic address: l.degenhardt@unsw.edu.au.
Centre Hospitalier de l’Université de Montréal · CAEastern Health · AUNew South Wales Department of Health · AUUniversity of Adelaide · AU

Funding

Integrating Multi-Assessment Protocols into PracticeR01DA014470 · NIDA · UNIVERSITY OF CALIFORNIA SAN FRANCISCO · PI GUYDISH, JOSEPH R · 2001 to 2003
$1.2M
Using existing data to understand and ameliorate risk in opioid agonist therapyR01DA044170 · NIDA · UNIVERSITY OF NEW SOUTH WALES · PI DEGENHARDT, LOUISA · 2017 to 2019
$641k
NIDA NIH HHS R01 DA014470NIDA NIH HHS R01 DA044170
6 · The paper itself

Abstract

backgroundThere has been much research on the efficacy and effectiveness of opioid agonist treatment (OAT), but less on its implementation and sustainability. A challenge internationally has been recruiting and retaining prescribers. This paper aims to characterise the prescribers in terms of OAT prescribing behaviours.

methodsRetrospective cohort study in New South Wales, Australia. Participants were 2199 OAT prescribers between 1 st August 2001-19th September 2018.We examined trends in initiation and cessation of OAT prescribers. Adjusted hazard ratios were calculated to estimate prescriber retention, adjusting for year of initiation, practice type, client load and treatment prescribed.

resultsThe rate of prescribers ceasing OAT prescribing has been increasing over time: a prescriber who initiated between 2016-2017 had over four times the risk of cessation compared with one who initiated before 2001, AHR: 4.77; [3.67-6.21]. The highest prescriber cessation rate was in prescribers who had prescribed for shorter time periods. The annual percentage of prescribers who ceased prescribing among those who prescribed for ≤5 years increased from 3% in 2001 to 20 % in 2017. By 2017 more prescribers were discontinuing prescribing than new prescribers were starting. Approximately 87 % (n = 25,167) of OAT clients were under the care of 20 % of OAT prescribers (n = 202); half had been prescribing OAT for 17+ years.

conclusionsOAT prescribing is increasingly concentrated in a small group of mature prescribers, and new prescribers are not being retained. There is a need to identify and respond to the reasons that contribute to newer prescribers to cease prescribing and put in place strategies to increase retention and broaden the base of doctors involved in such prescribing.

Indexed as

Opiate Substitution TreatmentAdultAnalgesics, OpioidAustraliaFemaleHumansMaleMethadoneNew South WalesOpioid-Related DisordersPhysiciansRetrospective StudiesAnalgesics, OpioidMethadoneBuprenorphineMethadoneOpioid agonist treatmentOpioid dependencePrescriberRetention

Identifiers

PMID33360851
PMCPMC7855715
OpenAlexW3115175907

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.