Evidence map›Paper›PMID 38023343›Full record

ArticleDrug and alcohol dependence reports2023

Co-occurring psychiatric disorders and disparities in buprenorphine utilization in opioid use disorder: An analysis of insurance claims.

Kevin Y Xu, Vivien Huang, Arthur Robin Williams, Caitlin E Martin, Alexander R Bazazi, Richard A Grucza

Open access · goldAbstract read
In one paragraph

Article in Drug and alcohol dependence reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
4.6field-weighted citation impact, top 5% 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

12 citing papers in PubMed, 16 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

6 authors at 5 institutions in 1 country.

Kevin Y XuHealth and Behavior Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Vivien HuangHealth and Behavior Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Arthur Robin WilliamsDepartment of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York, USA.
Caitlin E MartinDepartment of Obstetrics and Gynecology and the VCU Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
Alexander R BazaziDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA.
Richard A GruczaDepartment of Family and Community Medicine, St. Louis University, St. Louis, Missouri, USA.
Washington University in St. Louis · USNew York Psychoanalytic Society and Institute · USSaint Louis University · USUniversity of California, San Francisco · USVirginia Commonwealth University · US

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
Transdisciplinary Training in Addictions ResearchT32DA015035 · NIDA · WASHINGTON UNIVERSITY · PI Leopoldo J Cabassa, Patricia A Cavazos-Rehg · 2002 to 2026
$5.3M
Washington University Career Development Program in Drug Abuse and AddictionK12DA041449 · NIDA · WASHINGTON UNIVERSITY · PI Laura J. Bierut, Patricia A Cavazos-Rehg · 2017 to 2026
$4.2M
The Cascade of Care for Medicaid-Enrolled Youth with Opioid Use DisorderR01DA057566 · NIDA · MASSACHUSETTS GENERAL HOSPITAL · PI Scott Evan Hadland, Arthur R Williams · 2022 to 2026
$2.9M
Adaptation and Refinement of a Clinically Applicable Phenotypic Battery to Individualize Opioid Use Disorder Treatment for Women Through the Postpartum PeriodK23DA053507 · NIDA · VIRGINIA COMMONWEALTH UNIVERSITY · PI MARTIN, CAITLIN EILEEN · 2021 to 2025
$1.0M
AN EXAMINATION OF AGE-RELATED DISPARITIES IN MEDICATION ASSISTED TREATMENT AND ASSOCIATED OUTCOMESR21DA044744 · NIDA · WASHINGTON UNIVERSITY · PI BIERUT, LAURA J. · 2017 to 2018
$419k
NCATS NIH HHS UL1 TR002345NIDA NIH HHS K12 DA041449NIDA NIH HHS K23 DA053507NIDA NIH HHS R01 DA057566NIDA NIH HHS R21 DA044744NIDA NIH HHS T32 DA015035
6 · The paper itself

Abstract

Background: As the overdose crisis continues in the U.S. and Canada, opioid use disorder (OUD) treatment outcomes for people with co-occurring psychiatric disorders are not well characterized. Our objective was to examine the influence of co-occurring psychiatric disorders on buprenorphine initiation and discontinuation. Methods: This retrospective cohort study used multi-state administrative claims data in the U.S. to evaluate rates of buprenorphine initiation (relative to psychosocial treatment without medication) in a cohort of 236,198 people with OUD entering treatment, both with and without co-occurring psychiatric disorders, grouping by psychiatric disorder subtype (mood, psychotic, and anxiety-and-related disorders). Among people initiating buprenorphine, we assessed the influence of co-occurring psychiatric disorders on buprenorphine retention. We used multivariable Poisson regression to estimate buprenorphine initiation and Cox regression to estimate time to discontinuation, adjusting for all 3 classes of co-occurring disorders simultaneously and adjusting for baseline demographic and clinical characteristics. Results: Buprenorphine initiation occurred in 29.3 % of those with co-occurring anxiety-and-related disorders, compared to 25.9 % and 17.5 % in people with mood and psychotic disorders. Mood (adjusted-risk-ratio[aRR] = 0.82[95 % CI = 0.82-0.83]) and psychotic disorders (aRR = 0.95[0.94-0.96]) were associated with decreased initiation (versus psychosocial treatment), in contrast to greater initiation in the anxiety disorders cohort (aRR = 1.06[1.05-1.06]). We observed an increase in buprenorphine discontinuation associated with mood (adjusted-hazard-ratio[aHR] = 1.20[1.17-1.24]) and anxiety disorders (aHR = 1.12[1.09-1.14]), in contrast to no association between psychotic disorders and buprenorphine discontinuation. Conclusions: We observed underutilization of buprenorphine among people with co-occurring mood and psychotic disorders, as well as high buprenorphine discontinuation across anxiety, mood, and psychotic disorders.

Indexed as

BuprenorphineCo-occurring disordersInsurance claimsOpioid use disordersPsychiatric disordersPsychosisTreatment retention

Identifiers

PMID38023343
PMCPMC10630609
OpenAlexW4387826831

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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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.