Evidence map›Paper›PMID 39461121›Full record

Trial reportDrug and alcohol dependence2024

Correlates of post-hospitalization naltrexone adherence for alcohol use disorder.

Eden Y Bernstein, Kara M Magane, Kimberly A Dukes, Tibor P Palfai, Joo H Lee, Richard Saitz, Jeffrey H Samet

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Drug and alcohol dependence, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

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

  1. Pooled it
  2. Trial
  3. Review
  4. Article
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

7 authors.

Eden Y BernsteinDivision of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: eden.bernstein@cuanschutz.edu.
Kara M MaganeDepartment of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
Kimberly A DukesDepartment of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
Tibor P PalfaiDepartment of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
Joo H LeeBoston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Richard SaitzDepartment of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA; Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA; Grayken Center for Addiction, Boston Medical Center, Boston, MA, USA.
Jeffrey H SametDepartment of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA; Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA; Grayken Center for Addiction, Boston Medical Center, Boston, MA, USA.

Funding

Oral v Injection Naltrexone in Hospital: Comparative Effectiveness for AlcoholismR01AA021335 · NIAAA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI SAITZ, RICHARD · 2014 to 2019
$4.2M
NIAAA NIH HHS R01 AA021335
6 · The paper itself

Abstract

introductionHospitalizations present an opportunity to initiate naltrexone for patients with alcohol use disorder (AUD). Understanding factors associated with post-hospitalization adherence could inform practice.

methodsThis study is a secondary analysis of a clinical trial in which patients with AUD were randomized to oral (PO) versus long-acting injectable (LAI) naltrexone at hospital discharge. The outcome of this secondary analysis was naltrexone adherence 3 months after discharge, defined as receipt of at least 2 out of 3 monthly injections or the equivalent days of self-reported PO medication use (60 out of 90). We used baseline socio-demographics, substance use history, health status, healthcare utilization, and randomization arm to construct multivariable logistic regression models to identify correlates of adherence.

resultsWe evaluated patients who initiated naltrexone treatment, 124 randomized to PO and 120 to LAI (overall mean age 49 years, 80 % male, 51 % Black, 47 % unhoused, and 91 % with severe AUD). At 3 months, 50 % of patients were adherent. LAI naltrexone (aOR 3.88; 95 % CI 2.17-7.13), recent office visit (aOR 2.01; 95 % CI 1.10-3.72), and age (aOR per 10-year increase 1.37; 95 % CI 1.02-1.88) were associated with increased odds of adherence. Unhoused status (aOR 0.54; 95 % CI 0.30-0.98) and cocaine use (aOR 0.35; 95 % CI 0.17-0.71) were associated with decreased odds of adherence.

conclusionsLAI naltrexone for AUD at hospital discharge was associated with better adherence at 3 months vs PO. Access to LAI naltrexone and targeted interventions for patients with cocaine use or who are unhoused hold potential to improve naltrexone adherence.

Indexed as

Medication AdherenceNaltrexoneNarcotic AntagonistsAdministration, OralAdultAlcoholismDelayed-Action PreparationsFemaleHospitalizationHumansMaleMiddle AgedDelayed-Action PreparationsNaltrexoneNarcotic AntagonistsAdherenceAlcohol use disorderHospitalizationInjectableNaltrexoneOral

Identifiers

PMID39461121
PMCPMC11884669

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.