Evidence map›Paper›PMID 35315162›Full record

ArticleAddiction (Abingdon, England)2022

Population-level impact of initiating pharmacotherapy and linking to care people with opioid use disorder at inpatient medically managed withdrawal programs: an effectiveness and cost-effectiveness analysis.

Alexandra Savinkina, Rajapaksha W M A Madushani, Golnaz Eftekhari Yazdi, Jianing Wang, Joshua A Barocas, Jake R Morgan, Sabrina A Assoumou, Alexander Y Walley, Benjamin P Linas, Sean M Murphy

Open access · greenAbstract read
In one paragraph

Article in Addiction (Abingdon, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 15% 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

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 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

10 authors at 3 institutions in 1 country.

Alexandra SavinkinaSection of Infectious Diseases, Boston Medical Center (BMC), Boston, MA, USA.ORCID 0000-0002-5257-866X
Rajapaksha W M A MadushaniSection of Infectious Diseases, Boston Medical Center (BMC), Boston, MA, USA.
Golnaz Eftekhari YazdiSection of Infectious Diseases, Boston Medical Center (BMC), Boston, MA, USA.
Jianing WangSection of Infectious Diseases, Boston Medical Center (BMC), Boston, MA, USA.
Joshua A BarocasSection of Infectious Diseases, Boston Medical Center (BMC), Boston, MA, USA.ORCID 0000-0002-4155-4697
Jake R MorganBoston University School of Public Health, MA, USA.ORCID 0000-0002-1559-3983
Sabrina A AssoumouSection of Infectious Diseases, Boston Medical Center (BMC), Boston, MA, USA.ORCID 0000-0002-5169-620X
Alexander Y WalleyClinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Grayken Center for Addiction at Boston Medical Center, Boston, MA, USA.
Benjamin P LinasSection of Infectious Diseases, Boston Medical Center (BMC), Boston, MA, USA.
Sean M MurphyDepartment of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA.ORCID 0000-0001-9104-0670
Boston University · USBoston Medical Center · USCornell University · US

Funding

Utilization of health services after engagement with opioid use disorder (OUD) treatment provider by individuals with and without post-traumatic stress disorderP30DA040500 · NIDA · WEILL MEDICAL COLL OF CORNELL UNIV · PI ZACHARY Franklin MEISEL · 2015 to 2026
$20.7M
Researching Effective Strategies to Prevent Opioid Death (RESPOND)R01DA046527 · NIDA · BOSTON MEDICAL CENTER · PI Benjamin P. Linas · 2018 to 2026
$7.2M
NIDA NIH HHS P30 DA040500NIDA NIH HHS R01 DA046527
6 · The paper itself

Abstract

BACKGROUND AND

aimsMedications for opioid use disorder (MOUD) are shown to reduce opioid use and the risk of overdose. People with opioid use disorder (OUD) who exit inpatient medically managed withdrawal programs (detox) without initiating MOUD and linking to outpatient care have high rates of overdose. While detox encounters provide a theoretical opportunity for MOUD initiation, this is not ubiquitous in the United States. We used simulation modeling to estimate the population-level health effects and cost-effectiveness of a policy encouraging MOUD initiation during inpatient detox encounters. DESIGN, SETTING AND

participantsWe employed a dynamic population state-transition model to evaluate the effectiveness and cost-effectiveness of using detox programs as venues for initiating MOUD in Massachusetts, United States. We compared standard of care, where no detox patients initiate MOUD or link to outpatient MOUD providers, to strategies of offering MOUD to detox patients and linking those patients to outpatient MOUD. MEASURES: Budgetary impact to the Massachusetts health-care sector, incremental cost-effectiveness ratios (ICER) and total counts and percentage differences of fatal overdoses prevented.

findingsInitiating MOUD in detox with perfect linkage to outpatient MOUD would reduce fatal overdoses by 4.5% [95% confidence interval (CI) = 2.3-5.9], at an ICER of $56 000 per quality-adjusted life-year (QALY) gained, compared with the standard of care. With moderate linkage, fatal overdoses would be reduced by 2.3% (95% CI= 1.2-3.1) with an ICER of $78 500 per QALY gained, compared with standard of care. Budgetary increase to Massachusetts health-care spending ranged from 0.5-1%.

conclusionA simulation model indicates that initiation of medications for opioid use disorder and linkage policies among detox patients in Massachusetts, USA could prevent fatal opioid overdoses in the opioid use disorder population and would be cost-effective from a health-care sector perspective.

Indexed as

BuprenorphineDrug OverdoseOpioid-Related DisordersAnalgesics, OpioidCost-Benefit AnalysisHumansInpatientsOpiate Substitution TreatmentUnited StatesAnalgesics, OpioidBuprenorphineDetoxinjection drug usemortalityMOUDopioidssimulation modeling

Identifiers

PMID35315162
PMCPMC9377514
OpenAlexW4220717058

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.