Evidence map›Paper›PMID 35123246›Full record

ArticleThe International journal on drug policy2022

Evaluating how has care been affected by the Ontario COVID-19 Opioid Agonist Treatment Guidance: Patients' and prescribers' experiences with changes in unsupervised dosing.

Kim Corace, Kelly Suschinsky, Jennifer Wyman, Pamela Leece, Sue Cragg, Sarah Konefal, Priscille Pana, Susan Barrass, Amy Porath, Brian Hutton

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PubMed Full text at PMC Publisher
In one paragraph

Article in The International journal on drug policy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

17 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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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

10 authors.

Kim CoraceSubstance Use and Concurrent Disorders Program, Royal Ottawa Mental Health Centre, 1145 Carling Ave., Ottawa, ON, K1Z 7K4, Canada; Department of Psychiatry, Faculty of Medicine, University of Ottawa, 5457-1145 Carling Avenue, Ottawa, ON, K1Z 7K4, Canada; University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Ave., Ottawa, ON, K1Z 7K4, Canada; Ottawa Hospital Research Institute, 501 Smyth Road, Box 511, Ottawa, ON, K1H 8L6, Canada. Electronic address: kim.corace@theroyal.ca.
Kelly SuschinskySubstance Use and Concurrent Disorders Program, Royal Ottawa Mental Health Centre, 1145 Carling Ave., Ottawa, ON, K1Z 7K4, Canada.
Jennifer WymanDepartment of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada; Substance Use Service, Women's College Hospital, 76 Grenville Street, Floor 3, Toronto, ON, M5S 1B2, Canada.
Pamela LeeceDepartment of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada; Substance Use Service, Women's College Hospital, 76 Grenville Street, Floor 3, Toronto, ON, M5S 1B2, Canada; Public Health Ontario, 661 University Avenue, Suite 1701, Toronto, ON, M5G 1M1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, ON, M5T 3M7, Canada.
Sue CraggCanadian Centre on Substance Use and Addiction, 75 Albert Street, #500, Ottawa, ON, K1P 5E7, Canada.
Sarah KonefalCanadian Centre on Substance Use and Addiction, 75 Albert Street, #500, Ottawa, ON, K1P 5E7, Canada.
Priscille PanaCanadian Centre on Substance Use and Addiction, 75 Albert Street, #500, Ottawa, ON, K1P 5E7, Canada.
Susan BarrassCanadian Centre on Substance Use and Addiction, 75 Albert Street, #500, Ottawa, ON, K1P 5E7, Canada.
Amy PorathCanadian Centre on Substance Use and Addiction, 75 Albert Street, #500, Ottawa, ON, K1P 5E7, Canada.
Brian HuttonOttawa Hospital Research Institute, 501 Smyth Road, Box 511, Ottawa, ON, K1H 8L6, Canada; School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, ON, K1G 5Z3, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe COVID-19 pandemic has exacerbated the opioid crisis. Opioid-related deaths have increased and access to treatment services, including opioid agonist treatment (OAT), has been disrupted. The Ontario COVID-19 OAT Treatment Guidance document was developed to facilitate access to OAT and continuity of care during the pandemic, while supporting physical distancing measures. In particular, the Guidance expanded access to unsupervised OAT dosing. It is important to evaluate the changes in unsupervised OAT dosing after the release of the Ontario COVID-19 OAT Guidance based on patients' and prescribers' reports.

methodOnline questionnaires were developed collaboratively with people with lived and living expertise, prescribers, clinical experts, and researchers. Patients (N = 402) and prescribers (N = 100) reported their experiences with changes in unsupervised dosing during the first six months of the pandemic.

resultsMany patients (57%) reported receiving additional unsupervised OAT doses (i.e., take away doses). Patients who received additional unsupervised doses were not significantly more likely to report adverse health outcomes compared to patients who did not receive additional unsupervised doses. Patients with additional unsupervised doses and prescribers agreed that changes in OAT care were positive (e.g., reported an improved patient-prescriber relationship and more openness between patient and prescriber). Prescribers and some patients reported the need for continued flexibility in unsupervised doses after the pandemic restrictions lift.

conclusionsResults support the need to re-evaluate historical approaches to OAT care delivery, particularly unsupervised doses. It is crucial to implement policies, regulations, and supports to reduce barriers to OAT care during the pandemic and once the pandemic response restrictions are eased. Flexibility in OAT care delivery, particularly unsupervised dosing, will be key to providing patient-centred care for persons with opioid use disorder.

Indexed as

BuprenorphineCOVID-19Opioid-Related DisordersAnalgesics, OpioidHumansMethadoneOntarioOpiate Substitution TreatmentPandemicsAnalgesics, OpioidBuprenorphineMethadoneBuprenorphineCOVID-19MethadoneOpioid agonist treatmentSlow-release oral morphineUnsupervised doses

Identifiers

PMID35123246
PMCPMC8695187

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.