Evidence map›Paper›PMID 39103784›Full record

ArticleBMC health services research2024

Federal opioid agonist therapy policy: interrupted time series analysis of the impact of the methadone exemption removal across eight provinces in Canada.

Abhimanyu Sud, Chloe Campbell, Arani Sivakumar, Ross Upshur, Rahim Moineddin, Kellia Chiu

Abstract read
In one paragraph

Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

6 authors.

Abhimanyu SudTemerty Faculty of Medicine, University of Toronto, Toronto, Canada. abhimanyu.sud@utoronto.ca.
Chloe CampbellTemerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Arani SivakumarHumber River Health, Toronto, Canada.
Ross UpshurTemerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Rahim MoineddinTemerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Kellia ChiuTemerty Faculty of Medicine, University of Toronto, Toronto, Canada.

Funding

CIHR Quadruple Aim and Equity Catalyst Grant (QAE-180974)Health Canada, Substance Use and Addiction Program 1920-HQ-000031
6 · The paper itself

Abstract

backgroundFederal deregulation of opioid agonist therapies are an attractive policy option to improve access to opioid use disorder care and achieve widespread beneficial impacts on growing opioid-related harms. There have been few evaluations of such policy interventions and understanding effects can help policy planning across jurisdictions.

methodsUsing health administrative data from eight of ten Canadian provinces, this study evaluated the impacts of Health Canada's decision in May 2018 to rescind the requirement for Canadian health professionals to obtain an exemption from the Canadian Drugs and Substance Act to prescribe methadone for opioid use disorder. Over the study period of June 2017 to May 2019, we used descriptive statistics to capture overall trends in the number of agonist therapy prescribers across provinces and we used interrupted time series analysis to determine the effect of this decision on the trajectories of the agonist therapy prescribing workforces.

resultsThere were important baseline differences in the numbers of agonist therapy prescribers. The province with the highest concentration of prescribers had 7.5 more prescribers per 100,000 residents compared to the province with the lowest. All provinces showed encouraging growth in the number of prescribers through the study period, though the fastest growing province grew 4.5 times more than the slowest. Interrupted time series analyses demonstrated a range of effects of the federal policy intervention on the provinces, from clearly positive changes to possibly negative effects.

conclusionsFederal drug regulation policy change interacted in complex ways with provincial health professional regulation and healthcare delivery, kaleidoscoping the effects of federal policy intervention. For Canada and other health systems such as the US, federal policy must account for significant subnational variation in OUD epidemiology and drug regulation to maximize intended beneficial effects and mitigate the risks of negative effects.

Indexed as

Analgesics, OpioidDrug and Narcotic ControlHealth PolicyMethadoneOpiate Substitution TreatmentOpioid-Related DisordersAdministrative Claims, HealthcareBuprenorphineCanadaDrug PrescriptionsFederal GovernmentHumansInterrupted Time Series AnalysisAnalgesics, OpioidBuprenorphineMethadoneCanadaHealth policyInterrupted time series analysisMethadoneOpioid epidemicOpioid-related disordersOpioid substitution treatment

Identifiers

PMID39103784
PMCPMC11302312

What OpenQuestion holds

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LicenceCC BY
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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.