Evidence map›Paper›PMID 41093336›Full record

ArticleBMJ open2025

Comparative effectiveness of take-home dosing schedules for opioid agonist treatment in British Columbia, Canada: a target trial emulation protocol using a population-based observational study.

Megan Kurz, B Carolina Guerra-Alejos, Md Belal Hossain, Jeong Eun Min, Ruyu Yan, Julie Bruneau, Nicole L A Catherine, Sander Greenland, Paul Gustafson, Lindsay Hedden and 9 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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

19 authors.

Megan KurzCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0009-0001-8589-2006
B Carolina Guerra-AlejosCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.
Md Belal HossainCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0000-0003-4603-863X
Jeong Eun MinCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0000-0002-0968-722X
Ruyu YanCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.
Julie BruneauDépartement de médecine de famille et de médecine d'urgence, Université de Montréal, Montreal, Quebec, Canada.
Nicole L A CatherineChildren's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.ORCID http://orcid.org/0000-0002-1190-4326
Sander GreenlandDepartment of Epidemiology and Department of Statistics, UCLA, Los Angeles, California, USA.
Paul GustafsonStatistics, The University of British Columbia, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0000-0002-2375-5006
Lindsay HeddenFaculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
Ehsan KarimCentre for Advancing Health Outcomes, Vancouver, British Columbia, Canada.
Lawrence McCandlessFaculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
Seonaid NolanBritish Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.
Robert W PlattDepartments of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.
Paxton BachBritish Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.
Shaun SeamanMRC Biostatistics Unit, Cambridge, UK.ORCID http://orcid.org/0000-0003-3726-5937
U SiebertCenter for Health Decision Science, Department of Health Policy and Management, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.
M Eugenia SocíasBritish Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.
Bohdan NosykCentre for Advancing Health Outcomes, 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

introductionThe introduction of fentanyl and its analogues in the illicit drug supply has prompted greater emphasis on refining clinical treatment protocols to ensure sustained retention in opioid agonist treatment (OAT). Take-home dosing may lessen the treatment burden on clients and thus reduce the risk of treatment discontinuation. The evidence base supporting the use of take-home dosing, including the optimal duration of dispensations, is, however, limited. The objective of this study is to determine the comparative effectiveness of alternative take-home dosing schedules, as observed in clinical practice in British Columbia, Canada from 2010 to 2022. METHODS AND ANALYSIS: We propose to emulate a target trial with a population-level retrospective study of individuals initiating methadone or buprenorphine/naloxone between 1 January 2010 and 31 December 2022 who are 18 years of age or older and not currently incarcerated or pregnant with no history of cancer or palliative care. Our study will draw on nine linked health administrative databases from British Columbia and will evaluate take-home doses of 2-5 days, 6 days or >6 days compared with continuous daily dosing. The primary outcomes include OAT discontinuation and all-cause mortality on treatment. A causal per-protocol analysis is proposed with longitudinal matching and inverse probability of censoring weighting approaches to adjust for time-fixed and time-varying confounding. A range of sensitivity analyses will be executed to determine the robustness of results. 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. 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 ColumbiaDrug Administration ScheduleFemaleHumansMaleObservational Studies as TopicRetrospective StudiesAnalgesics, OpioidBuprenorphine, Naloxone Drug CombinationMethadoneEPIDEMIOLOGYSTATISTICS & RESEARCH METHODSSubstance misuse

Identifiers

PMID41093336
PMCPMC12530365

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.