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AHRQ Research Studies Date
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- Access to Care (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedChing JH, Owens DK, Trafton JA
Impact of treatment duration on mortality among Veterans with opioid use disorder in the United States Veterans Health Administration.
This study used simulation of a Veterans Health Administration cohort to identify the opioid use disorder (OUD) treatment durations necessary for the elevated mortality risks during treatment transitions balanced by reductions in mortality while receiving medication-assisted treatment (MAT) with methadone or buprenorphine. A simulated cohort of 10,000 individuals with OUD was created by using parameters obtained through calibration and published meta-analyses of studies from North America, Europe, and Australia. Methadone treatment for 4 months or longer or buprenorphine for 2 months or longer resulted in 54 and 65 fewer deaths relative to not receiving MAT for the same duration. The authors estimated shorter treatment durations necessary to achieve net mortality benefits of 2 months or longer for methadone and 1 month or longer for buprenorphine. Necessary treatment increased more with smaller mortality reductions on treatment with larger relative risks during treatment transitions.
AHRQ-funded; HS027935; HS026128.
Citation: Ching JH, Owens DK, Trafton JA .
Impact of treatment duration on mortality among Veterans with opioid use disorder in the United States Veterans Health Administration.
Addiction 2021 Dec;116(12):3494-503. doi: 10.1111/add.15574.
AHRQ-funded; HS027935; HS026128..
AHRQ-funded; HS027935; HS026128..
Keywords: Opioids, Substance Abuse, Behavioral Health, Mortality
Jonas DE, Barclay C, Grammer D
The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care.
This paper describes a randomized, controlled trial to evaluate the effect of primary care practice facilitation and telehealth services on evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use in primary care practices in North Carolina with 10 or fewer providers. The study will produce important evidence about the effect of practice facilitation on uptake of evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use when delivered on a large scale to small and medium-sized practices. The results of this rigorously conducted evaluation are expected to have a positive impact by accelerating the dissemination and implementation of evidence related to unhealthy alcohol use into primary care practices.
AHRQ-funded; HS027078.
Citation: Jonas DE, Barclay C, Grammer D .
The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care.
Trials 2021 Nov 16;22(1):810. doi: 10.1186/s13063-021-05641-7..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Screening, Implementation
Wyse JJ, Morasco BJ, Dougherty J
Adjunct interventions to standard medical management of buprenorphine in outpatient settings: a systematic review of the evidence.
A growing body of research has examined adjunctive interventions supportive of engagement and retention in treatment among patients receiving buprenorphine for opioid use disorder (OUD). In this study the investigators conducted a systematic review of the literature addressing the effect on key outcomes of adjunctive interventions provided alongside standard medical management of buprenorphine in outpatient settings.
AHRQ-funded; HS026370.
Citation: Wyse JJ, Morasco BJ, Dougherty J .
Adjunct interventions to standard medical management of buprenorphine in outpatient settings: a systematic review of the evidence.
Drug Alcohol Depend 2021 Nov 1;228:108923. doi: 10.1016/j.drugalcdep.2021.108923..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication
Cook RR, Torralva R, King C
Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.
This study examined the associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder (OUD) among people living with uncontrolled HIV disease. Data from a multisite clinical trial was used to compare extended-release naltrexone (XR-NTX) with treatment as usual (TAU: buprenorphine or methadone) to achieve HIV viral suppression among people with OUD and uncontrolled HIV disease. Exposure to fentanyl use was measured by urine drug screening. The cohort was 11 participants had an average age of 47 years, were 62% male, 57% Black and 13% Hispanic. Baseline fentanyl use was 64% for participants. Participants with baseline fentanyl use were 11 times less likely to initiative XR-NTX than those negative for fentanyl, but there was no evidence that fentanyl use impacted the likelihood of TAU initiation.
AHRQ-funded; HS026370.
Citation: Cook RR, Torralva R, King C .
Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.
Drug Alcohol Depend 2021 Nov 1;228:109077. doi: 10.1016/j.drugalcdep.2021.109077..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Human Immunodeficiency Virus (HIV), Chronic Conditions
Sussman AL, Crawford JN, Brakey HR
Use of a benchmark tracking assessment to support expansion of buprenorphine for treatment of opioid use disorder in primary care.
Barriers to the expansion of opioid use disorder (OUD) treatment in primary care using buprenorphine are well documented. Providers require support along a continuum. A systematic tracking framework to enhance provider progress along this continuum is lacking. The investigators developed a benchmark tracking assessment (BTA) as part of data collection in a 5-year study to examine the impact of provider participation in an online intervention to support expansion of buprenorphine treatment for OUD in rural primary care.
AHRQ-funded; HS025345.
Citation: Sussman AL, Crawford JN, Brakey HR .
Use of a benchmark tracking assessment to support expansion of buprenorphine for treatment of opioid use disorder in primary care.
J Am Board Fam Med 2021 Nov-Dec;34(6):1216-20. doi: 10.3122/jabfm.2021.06.210111..
Keywords: Opioids, Primary Care, Medication, Substance Abuse, Behavioral Health
Lipira L, Leichtling G, Cook RR
Predictors of having naloxone in urban and rural Oregon findings from NHBS and the OR-HOPE study.
Investigators determined the proportion of people who had naloxone and identified predictors of naloxone ownership among two samples of people who inject drugs (PWID) who use opioids in Portland and rural Western Oregon. Using data from participants in two studies, they found that 61% of the Portland group and 30 % of the Oregon group had naloxone. The authors concluded that naloxone ownership was insufficient and highly variable among two samples of PWID who use opioids in Oregon. Further, people who use methamphetamine, males, and people experiencing homelessness may be at increased risk for not having naloxone, and syringe service programs may play a key role in improving access.
AHRQ-funded; HS026370.
Citation: Lipira L, Leichtling G, Cook RR .
Predictors of having naloxone in urban and rural Oregon findings from NHBS and the OR-HOPE study.
Drug Alcohol Depend 2021 Oct 1;227:108912. doi: 10.1016/j.drugalcdep.2021.108912..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication
Lillie KM, Shaw J, Jansen KJ
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
Opioid-related disparities are magnified among Alaska Native and American Indian (ANAI) people. Yet, no outcome studies on medication for addiction treatment, an effective treatment in other populations, among ANAI people exist. The objective of this study was to identify variables associated with buprenorphine/naloxone retention among ANAI people with opioid use disorder (OUD). The investigators concluded that younger patients and those with co-occurring substance use remained at higher risk of discontinuing buprenorphine/naloxone treatment for OUD in this population of ANAI people.
AHRQ-funded; HS023207.
Citation: Lillie KM, Shaw J, Jansen KJ .
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
J Addict Med 2021 Jul-Aug 01;15(4):297-302. doi: 10.1097/adm.0000000000000757..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication, Racial and Ethnic Minorities, Vulnerable Populations
Simon CB, Klein JW, Bradley KA
Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders.
One potential challenge of treating OUD in primary care is comorbidity. Mental health and substance use disorders and chronic pain are common in patients with Opioid Use Disorders (OUDs) in specialty OUD treatment settings and on confidential surveys, but the prevalence of such comorbidity in primary care patients with OUD has not been confirmed. This brief report addressed that gap.
AHRQ-funded; HS023173.
Citation: Simon CB, Klein JW, Bradley KA .
Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders.
J Gen Intern Med 2021 Jun;36(6):1799-801. doi: 10.1007/s11606-020-05820-3..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Primary Care
Tsui JI, Akosile MA, Lapham GT
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV. The objective of this retrospective observational cohort study was to describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV.
AHRQ-funded; HS026369.
Citation: Tsui JI, Akosile MA, Lapham GT .
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
J Gen Intern Med 2021 Apr;36(4):930-37. doi: 10.1007/s11606-020-06389-7..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Hepatitis, Human Immunodeficiency Virus (HIV), Primary Care
Anderson KE, Alexander GC, Niles L
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
Investigators sought to measure quality of non-opioid use disorder (OUD) preventive and chronic illness care and care coordination for individuals with OUD compared with individuals without OUD. They used deidentified data on outpatients throughout the United States from claims for commercially insured and Medicare Advantage enrollees aged 18 years or older with diagnosis codes for OUD. They found that individuals with OUD have moderately lower quality of care across preventive and chronic illness care and care coordination for non-OUD care compared with individuals without OUD. They recommended more attention to measurement and improvement of non-OUD care for these individuals.
AHRQ-funded; HS000029.
Citation: Anderson KE, Alexander GC, Niles L .
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
JAMA Netw Open 2021 Apr;4(4):e214925. doi: 10.1001/jamanetworkopen.2021.4925..
Keywords: Opioids, Medication, Substance Abuse, Quality Indicators (QIs), Quality of Care, Behavioral Health, Chronic Conditions, Prevention
Magee LA, Fortenberry JD, Rosenman M
Two-year prevalence rates of mental health and substance use disorder diagnoses among repeat arrestees.
Investigators examined the prevalence of mental health and substance use diagnoses among arrestees and repeat arrestees to identify opportunities for intervention. Their retrospective cohort study linked police arrest and clinical care data at the individual level for persons arrested in Indianapolis, Indiana, in 2016. They found that linked clinical and criminal justice data systems identified individuals at risk of repeat arrest and informed opportunities for interventions aimed at low-level offenders with behavioral health needs.
AHRQ-funded; HS023318.
Citation: Magee LA, Fortenberry JD, Rosenman M .
Two-year prevalence rates of mental health and substance use disorder diagnoses among repeat arrestees.
Health Justice 2021 Jan 7;9(1):2. doi: 10.1186/s40352-020-00126-2..
Keywords: Behavioral Health, Substance Abuse, Vulnerable Populations
Salvador JG, Bhatt SR, Jacobsohn VC
Feasibility and acceptability of an online ECHO intervention to expand access to medications for treatment of opioid use disorder, psychosocial treatments and supports.
This study examined acceptability and feasibility of an online Extensions for Community Healthcare Outcomes (ECHO) model intervention developed to support rural primary care clinics to expand treatment and is part of a larger study tracking the impact of participation in this ECHO on expansion of medications for opioid use disorder (MOUD) in rural primary care. Using qualitative interviews and post-session questionnaires across 27 rural clinics in New Mexico, findings suggested evidence of feasibility and acceptability of MOUD ECHO to support expansion of this treatment.
AHRQ-funded; HS025345.
Citation: Salvador JG, Bhatt SR, Jacobsohn VC .
Feasibility and acceptability of an online ECHO intervention to expand access to medications for treatment of opioid use disorder, psychosocial treatments and supports.
Subst Abus 2021;42(4):610-17. doi: 10.1080/08897077.2020.1806184..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication, Access to Care, Rural Health, Primary Care, Patient-Centered Healthcare
Tong ST, Kato EU, Nix MP
AHRQ Author: Tong ST, Kato EU, Nix, MP, Bierman, AS
Help for primary care practitioners in addressing older adult alcohol and opioid use.
Unhealthy alcohol and opioid use are growing problems among older adults who are at increased risk for harms from both alcohol and opioid use. Primary care practices can play an important role in addressing this problem, but need support in implementing evidence-based practices. This article provides help for primary care practitioners in addressing older adult alcohol and opioid use.
AHRQ-authored.
Citation: Tong ST, Kato EU, Nix MP .
Help for primary care practitioners in addressing older adult alcohol and opioid use.
Generations Journal 2020-2021 Winter;44(4)..
Keywords: Elderly, Primary Care, Alcohol Use, Opioids, Substance Abuse, Behavioral Health