Evidence map›Paper›PMID 37748421›Full record

ArticleDrug and alcohol dependence2023

Racial/ethnic disparities in timely receipt of buprenorphine among Medicare disability beneficiaries.

Jennifer Miles, Peter Treitler, Richard Hermida, Amesika N Nyaku, Kosali Simon, Sumedha Gupta, Stephen Crystal, Hillary Samples

Abstract read
In one paragraph

Article in Drug and alcohol dependence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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

5 citing papers in PubMed.

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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

8 authors.

Jennifer MilesRutgers Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA. Electronic address: jm2462@ssw.rutgers.edu.
Peter TreitlerRutgers Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA; School of Social Work, Rutgers University, New Brunswick, NJ, USA.
Richard HermidaRutgers Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA.
Amesika N NyakuDepartment of Medicine, Division of Infectious Diseases, Rutgers New Jersey Medical School, Newark, NJ, USA.
Kosali SimonO'Neill School of Public and Environmental Affairs, Indiana University, Bloomington, IN, USA; National Bureau of Economic Research, Cambridge, MA, USA.
Sumedha GuptaDepartment of Economics, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
Stephen CrystalRutgers Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA; School of Social Work, Rutgers University, New Brunswick, NJ, USA; School of Public Health, Rutgers University, Piscataway, NJ, USA.
Hillary SamplesRutgers Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA; Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, USA.

Funding

New Jersey Alliance for Clinical Translational Science: NJ ACTSUL1TR003017 · NCATS · RUTGERS BIOMEDICAL/HEALTH SCIENCES-RBHS · PI PANETTIERI, REYNOLD ALEXANDER · 2019 to 2023
$28.9M
Improving MOUD Access, Opioid-Related Outcomes and Equity Among Medicare Beneficiaries with DisabilityR01DA057568 · NIDA · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · PI Stephen Crystal · 2022 to 2026
$3.7M
Opioid Overdoses among Medicaid Beneficiaries: Predictors, Outcomes, and State Policy EffectsR01DA047347 · NIDA · RUTGERS, THE STATE UNIV OF N.J. · PI CRYSTAL, STEPHEN · 2019 to 2022
$3.1M
NRSA TrainingTL1TR003019 · NCATS · RUTGERS BIOMEDICAL/HEALTH SCIENCES-RBHS · PI SCOTTO, KATHLEEN W. · 2019 to 2023
$1.9M
Implementing Integrated Services for People With HIV and Opioid Use DisorderK23DA053989 · NIDA · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · PI NYAKU, AMESIKA · 2021 to 2025
$1.0M
Multi-level associations between opioid use and overdose: Individual, clinical, and population-based risk factors for fatalityK01DA049950 · NIDA · RUTGERS BIOMEDICAL/HEALTH SCIENCES-RBHS · PI SAMPLES, HILLARY · 2020 to 2024
$981k
NCATS NIH HHS TL1 TR003019NCATS NIH HHS UL1 TR003017NIDA NIH HHS K01 DA049950NIDA NIH HHS K23 DA053989NIDA NIH HHS R01 DA047347NIDA NIH HHS R01 DA057568
6 · The paper itself

Abstract

backgroundMedicare disability beneficiaries (MDBs) have disproportionately high risk of opioid use disorder (OUD) and related harms given high rates of comorbidities and high-dose opioid prescribing. Despite this increased risk, little is known about timely receipt of medication for opioid use disorder (MOUD), including potential disparities by patient race/ethnicity or moderation by county-level characteristics.

methodsNational Medicare claims for a sample of MDBs with incident OUD diagnosis between March 2016 and June 2019 were linked with county-level data. Multivariable mixed effects Cox proportional hazards models estimated time (in days) to buprenorphine receipt within 180 days of incident OUD diagnosis. Primary exposures included individual-level race/ethnicity and county-level buprenorphine prescriber availability, percent non-Hispanic white (NHW) residents, and Social Deprivation Index (SDI) score.

resultsThe sample (n=233,079) was predominantly White (72.3%), ≥45 years old (76.3%), and male (54.8%). Black (adjusted hazard ratio [aHR]=0.50; 95% CI, 0.47-0.54), Asian/Pacific Islander (aHR=0.54; 95% CI, 0.41-0.72), Hispanic/Latinx (aHR=0.81; 95% CI, 0.76-0.87), and Other racial/ethnic groups (aHR=0.75; 95% CI, 0.58-0.97) had a lower likelihood of timely buprenorphine than non-Hispanic white beneficiaries after adjusting for individual and county-level confounders. Timely buprenorphine receipt was positively associated with county-level buprenorphine prescriber availability (aHR=1.05; 95% CI, 1.04-1.07), percent non-Hispanic white residents (aHR=1.01; 95% CI, 1.00-1.01), and SDI (aHR=1.06; 95% CI, 1.01-1.10).

conclusionsRacial/ethnic disparities highlight the need to improve access to care for underserved groups. Implementing equity-focused quality and performance measures and developing interventions to increase office-based buprenorphine prescribing in predominantly minority race/ethnicity counties may reduce disparities in timely access to medication for OUD.

Indexed as

BuprenorphineOpioid-Related DisordersAgedAnalgesics, OpioidHumansMaleMedicareMiddle AgedOpiate Substitution TreatmentPractice Patterns, Physicians'United StatesAnalgesics, OpioidBuprenorphineBuprenorphineCommunity characteristicsDisparitiesMedicare disability beneficiariesOpioid use disorder

Identifiers

PMID37748421
PMCPMC10615876

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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.