Evidence map›Paper›PMID 40784760›Full record

ArticleBMJ open2025

Comparative effectiveness of maintenance doses of opioid agonist treatment among individuals with opioid use disorder: a target trial emulation protocol using a population-based observational study.

Michelle Zanette, Jeong Eun Min, Fahmida Homayra, Paxton Bach, M Eugenia Socías, Julie Bruneau, P Todd Korthuis, Ehsan Karim, Shaun Seaman, Nikki Bozinoff and 2 more

Abstract read
In one paragraph

Article in BMJ open, 2025. 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. 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

12 authors.

Michelle ZanetteCentre for Advancing Health Outcomes, Providence Health Care, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0009-0007-8469-7210
Jeong Eun MinCentre for Advancing Health Outcomes, Providence Health Care, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0000-0002-0968-722X
Fahmida HomayraCentre for Advancing Health Outcomes, Providence Health Care, Vancouver, British Columbia, Canada.
Paxton BachDepartment of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
M Eugenia SocíasBritish Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.
Julie BruneauCentre de Recherche, Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada.
P Todd KorthuisDepartment of Medicine, Oregon Health & Science University, Portland, Oregon, USA.
Ehsan KarimCentre for Advancing Health Outcomes, Providence Health Care, Vancouver, British Columbia, Canada.
Shaun SeamanMRC Biostatistics Unit, University of Cambridge Institute of Public Health, Cambridge, UK.ORCID http://orcid.org/0000-0003-3726-5937
Nikki BozinoffCampbell Family Mental Health Research Institute; Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Mary Clare KennedyBritish Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.
Bohdan NosykCentre for Advancing Health Outcomes, Providence Health Care, Vancouver, British Columbia, Canada bnosyk@sfu.ca.ORCID http://orcid.org/0000-0003-2513-3718

Funding

DAT-Emulating target trials with big data to strengthen the evidence base for the clinical management of opioid use disorderR01DA050629 · NIDA · SIMON FRASER UNIVERSITY · PI NOSYK, BOHDAN · 2021 to 2025
$2.4M
NIDA NIH HHS R01 DA050629
6 · The paper itself

Abstract

introductionOpioid agonist treatment (OAT) prescribing patterns have shifted in recent years in British Columbia (BC), Canada due to the increasingly toxic unregulated drug supply. Experimental evidence to support guidelines on the effectiveness of maintaining clients at different maintenance dosage levels is incomplete and outdated for the fentanyl era. Our objective is to assess the risk of treatment discontinuation and mortality among individuals receiving different maintenance dosage strategies for OAT with methadone, buprenorphine/naloxone or slow-release oral morphine (SROM) at the population level in BC, Canada. METHODS AND ANALYSIS: We propose a retrospective population-level study of BC residents initiating OAT on methadone, buprenorphine/naloxone or SROM between 1 January 2010 and 31 December 2022 who were ≥18 years of age with no known pregnancy, no history of cancer diagnosis or receiving palliative care and not currently incarcerated. Our study will employ health administrative databases linked at the individual level to emulate a target trial per OAT type where individuals will be assigned to discrete maintenance dosing strategies, according to the full range observed in BC during the study period. Primary outcomes include treatment discontinuation and all-cause mortality. To determine the effectiveness of alternative maintenance doses, we will emulate a 'per-protocol' trial using a clone-censor-weight approach to adjust for measured time-dependent confounding by indication. ETHICS AND DISSEMINATION: The protocol, cohort creation and analysis plan have been classified and approved as a quality improvement initiative by Providence Health Care Research Ethics Board and the Simon Fraser University Office of Research Ethics. All data are deidentified, securely stored and accessed in accordance with provincial privacy regulations. Results will be disseminated and shared with local advocacy groups and decision-makers, developers of national and international clinical guidelines, presented at national and international conferences and published in peer-reviewed journals electronically and in print.

Indexed as

Analgesics, OpioidBuprenorphine, Naloxone Drug CombinationMethadoneOpiate Substitution TreatmentOpioid-Related DisordersAdultBritish ColumbiaFemaleHumansMaleMorphineNarcotic AntagonistsObservational Studies as TopicRetrospective StudiesAnalgesics, OpioidBuprenorphine, Naloxone Drug CombinationMethadoneMorphineNarcotic AntagonistsEPIDEMIOLOGYSTATISTICS & RESEARCH METHODSSubstance misuse

Identifiers

PMID40784760
PMCPMC12359485

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.