Evidence map›Paper›PMID 38277422›Full record

ArticlePLOS global public health2024

Preferences and decisional considerations relating to opioid agonist therapy among Ukrainian people who use drugs: A conjoint analysis survey.

Daniel J Bromberg, Lynn M Madden, Liana Fraenkel, Dharushana Muthulingam, Delaney Rhoades, Sergii Dvoriak, Kostyantyn Dumchev, Iryna Pykalo, Frederick L Altice

Abstract read
In one paragraph

Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
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

9 authors.

Daniel J BrombergDepartment of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America.ORCID https://orcid.org/0000-0003-0584-7238
Lynn M MaddenAPT Foundation, New Haven, Connecticut, United States of America.
Liana FraenkelDivision of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America.
Dharushana MuthulingamDivision of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, United States of America.
Delaney RhoadesDivision of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America.ORCID https://orcid.org/0000-0001-5750-7804
Sergii DvoriakEuropean Institute of Public Health Policy, Kyiv, Ukraine.
Kostyantyn DumchevEuropean Institute of Public Health Policy, Kyiv, Ukraine.
Iryna PykaloEuropean Institute of Public Health Policy, Kyiv, Ukraine.
Frederick L AlticeAPT Foundation, New Haven, Connecticut, United States of America.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Research Mentoring and Building Capacity of underrepresented Minority Research Scientists in India.D43TW010540 · FIC · YALE UNIVERSITY · PI MICHELE BARRY, Eva Harris · 2017 to 2026
$15.5M
Expanding Medication Assisted Therapy in Ukraine (ExMAT)R01DA033679 · NIDA · YALE UNIVERSITY · PI ALTICE, FREDERICK LEWIS · 2012 to 2021
$6.4M
TRAINING IN THE PATHOGENESIS OF INFECTIOUS DISEASEST32AI007517 · NIAID · YALE UNIVERSITY · PI Jaimie Meyer, Albert C Shaw · 1997 to 2026
$6.1M
Integrating Addiction Treatment and HIV Services into Primary Care Clinics in UkraineR01DA043125 · NIDA · YALE UNIVERSITY · PI ALTICE, FREDERICK LEWIS · 2016 to 2021
$4.4M
Integrating Treatment for Mental Disorders in Methadone Clinics in UkraineR01DA045384 · NIDA · UKRAINIAN INSTITUTE ON PUBLIC HEALTH POLICY · PI DVORIAK, SERGII · 2021 to 2022
$884k
Modeling the impact and cost-effectiveness of opioid agonist treatments to reduce the negative consequences of incarceration on HIV and TB transmission in Eastern Europe and Central AsiaR21DA047902 · NIDA · YALE UNIVERSITY · PI ALTICE, FREDERICK LEWIS · 2020 to 2021
$378k
Developing, Implementing, and Pilot Testing an Informed Decision Aid for Opioid Agonist Therapies for Prisoners in UkraineF31DA054861 · NIDA · YALE UNIVERSITY · PI BROMBERG, DANIEL J · 2021 to 2023
$94k
FIC NIH HHS D43 TW010540NCATS NIH HHS UL1 TR001863NIAID NIH HHS T32 AI007517NIDA NIH HHS F31 DA054861NIDA NIH HHS R01 DA033679NIDA NIH HHS R01 DA043125NIDA NIH HHS R01 DA045384NIDA NIH HHS R21 DA047902
6 · The paper itself

Abstract

Scaling up opioid agonist therapies (OAT) is the most effective strategy to control combined HIV and opioid epidemics, especially in Eastern Europe and Central Asia (EECA), where HIV incidence and mortality continue to increase. Patient concerns about OAT, however, have undermined scale-up. The objective of this study is to understand Ukrainian opioid use disorder patient preferences about OAT to guide the development of an evidence-informed decision aid for clinical decision-making. We conducted a conjoint-based choice (CBC) survey. Participants were asked to about their preferences relating to 7 attributes of OAT (cost, dosing frequency, concerns about withdrawal symptoms, adverse side effects, improvements in quality of life, precipitation of withdrawal and legislative requirements to be registered as a drug dependent person) and 20 attribute levels for receiving OAT under differing potential treatment constraints. Data were analyzed using Hierarchical Bayesian models. Using respondent-driven sampling and random sampling, we recruited 2,028 people who inject drugs with opioid use disorder. Relative importance (RIS) and partial-worth utility scores (PWUS) were used to assess preferences for attributes and thresholds within each attribute. Cost and dosing frequency were the most important attributes (RIS = 39.2% and RIS = 25.2%, respectively) to potential patients, followed by concerns about withdrawal symptoms (RIS = 10.8%), adverse side effects (RIS = 9.0%), quality-of-life improvement (RIS = 7.5%), precipitation of euphoria (5.2%) and requirement to be registered as a drug- dependent person (RIS = 3.1%). The monthly cost-threshold for willingness-to-pay was 1,900 UAH ($70 USD). In Ukraine, where both governmental and private OAT clinics have emerged and provide markedly different delivery strategies, preferences are mostly driven by out-of-pocket expenses, despite many patients being willing to pay for OAT. Programmatic demands (flexibility and ease of acquiring medications) remain an important consideration while for a minority, clinical concerns about withdrawal symptoms, adverse side effects and OAT impact on life play a smaller role.

Identifiers

PMID38277422
PMCPMC10817130

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Registered trials

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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.