Evidence map›Paper›PMID 34854083›Full record

ArticleHealth services research2022

Therapeutic relationships between Veterans and buprenorphine providers and effects on treatment retention.

Jayamalathi Priyanka Vakkalanka, Brian C Lund, Stephan Arndt, William Field, Mary Charlton, Marcia M Ward, Ryan M Carnahan

Open access · greenAbstract read
In one paragraph

Article in Health services research, 2022. 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
0.6field-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

3 citing papers in PubMed, 4 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 1 institution in 1 country.

Jayamalathi Priyanka VakkalankaDepartment of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA.ORCID 0000-0002-6419-3433
Brian C LundDepartment of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA.
Stephan ArndtDepartment of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa, USA.ORCID 0000-0003-0783-8204
William FieldDepartment of Occupational and Environmental Health, University of Iowa College of Public Health, Iowa City, Iowa, USA.ORCID 0000-0002-4381-2063
Mary CharltonDepartment of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA.
Marcia M WardDepartment of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa, USA.ORCID 0000-0003-1948-1302
Ryan M CarnahanDepartment of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA.ORCID 0000-0002-7478-4739
University of Iowa · US

Funding

The Heartland Center for Occupational Health and Safety Education and Research CenterT42OH008491 · OH · UNIVERSITY OF IOWA · PI O'SHAUGHNESSY, PATRICK T · 2005 to 2025
$31.7M
Medication Assisted Therapies for Opioid Use Disorder among US Veterans: The Impact of Therapeutic History and Telehealth on Health OutcomesR36DA050878 · NIDA · UNIVERSITY OF IOWA · PI VAKKALANKA, JAYAMALATHI PRIYANKA · 2020 to 2020
$37k
ACL HHS T42OH008491NIDA NIH HHS R36 DA050878NIOSH CDC HHS T42 OH008491
6 · The paper itself

Abstract

objectiveTo examine the extent to which there was any therapeutic relationship between Veterans and their initial buprenorphine provider and whether the presence of this relationship influenced treatment retention. DATA SOURCES: National, secondary administrative data used from the Veterans Health Administration (VHA), 2008-2017. STUDY

designRetrospective cohort study. The primary exposure was a therapeutic relationship between the Veteran and buprenorphine provider, defined as the presence of a previous visit or medication prescribed by the provider in the 2 years preceding buprenorphine treatment initiation. The primary outcome was treatment discontinuation, evaluated as 14 days of absence of medication from initiation through 1 year. DATA COLLECTION/EXTRACTION

methodsAdult Veterans (age ≥ 18 years) diagnosed with opioid use disorder and treated with buprenorphine or buprenorphine/naloxone within the VHA system were included in this study. We excluded those receiving buprenorphine patches, those with documentation of a metastatic tumor diagnosis within 2 years prior to buprenorphine initiation, and those without geographical information on rurality. PRINCIPAL

findingsA total of 28,791 Veterans were included in the study. Within the overall study sample, 56.3% (n = 16,206) of Veterans previously had at least one outpatient encounter with their initial buprenorphine provider, and 24.9% (n = 7174) of Veterans previously had at least one prescription from that provider in the 2 years preceding buprenorphine initiation. There was no significant or clinically meaningful association between therapeutic relationship history and treatment retention when defined as visit history (aHR: 0.99; 95% CI: 0.96, 1.02) or medication history (aHR: 1.03; 95% CI: 1.00, 1.07).

conclusionsVeterans initiating buprenorphine frequently did not have a therapeutic history with their initial buprenorphine provider, but this relationship was not associated with treatment retention. Future work should investigate how the quality of Veteran-provider therapeutic relationships influences opioid use dependence management and whether eliminating training requirements for providers might affect access to buprenorphine, and subsequently, treatment initiation and retention.

Indexed as

BuprenorphineOpioid-Related DisordersVeteransAdolescentAdultAnalgesics, OpioidHumansOpiate Substitution TreatmentRetrospective StudiesAnalgesics, OpioidBuprenorphineaccess/demand/utilization of serviceschemical dependencymental healthpharmaceuticals: prescribing/use/costsrural healthsubstance abuse: alcoholtobaccoVA healthcare system

Identifiers

PMID34854083
PMCPMC8928033
OpenAlexW3215434544

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.