Social determinants of health and emergency department utilization among adults receiving buprenorphine for opioid use disorder.
Buprenorphine
Emergency department
Healthcare utilization
Opioid use disorder
Social determinants of health
Substance use disorder treatment
Journal
Drug and alcohol dependence reports
ISSN: 2772-7246
Titre abrégé: Drug Alcohol Depend Rep
Pays: Netherlands
ID NLM: 9918350383506676
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
entrez:
5
7
2022
pubmed:
6
7
2022
medline:
6
7
2022
Statut:
ppublish
Résumé
Individuals with opioid use disorder (OUD) use the emergency department (ED) at high rates. Medication treatment for OUD (MOUD) is associated with reduced ED utilization. However, individuals receiving MOUD still utilize ED services at higher rates than the general population. The objective of this study is to compare the psychosocial and clinical characteristics of those who do and do not utilize ED services based on the Healthy People 2030 framework regarding social determinants of health (SDoH) among a sample of individuals receiving MOUD. Participants receiving buprenorphine for OUD at an outpatient addiction clinic completed a cross-sectional survey between July and September 2019. A 6-month prospective medical record review was conducted. The primary outcome was ED visit (yes/no) during the 6-month study period. Demographic, psychosocial, and clinical characteristics were gathered from survey measures and chart abstraction. Chi square and T-tests tested differences by ED utilization. Participants (n=142) were 54.9% female and 68.8% Black, with an average age of 43.2 years (SD=12.5). Of the participants, 38.7% visited the ED in the study period, primarily for infectious or musculoskeletal causes. Participants with an ED visit were more likely to be Black (p=.011), have less social support (p=.030), more medical comorbidities (p=.008) including chronic pain (p=.045), and more visits with an addiction provider in the study period (p=.009). Factors associated with ED utilization among individuals receiving buprenorphine for OUD include low social support and medical comorbidities, including chronic pain. More research is needed on modifiable SDoH that influence ED utilization.
Sections du résumé
Background
UNASSIGNED
Individuals with opioid use disorder (OUD) use the emergency department (ED) at high rates. Medication treatment for OUD (MOUD) is associated with reduced ED utilization. However, individuals receiving MOUD still utilize ED services at higher rates than the general population. The objective of this study is to compare the psychosocial and clinical characteristics of those who do and do not utilize ED services based on the Healthy People 2030 framework regarding social determinants of health (SDoH) among a sample of individuals receiving MOUD.
Methods
UNASSIGNED
Participants receiving buprenorphine for OUD at an outpatient addiction clinic completed a cross-sectional survey between July and September 2019. A 6-month prospective medical record review was conducted. The primary outcome was ED visit (yes/no) during the 6-month study period. Demographic, psychosocial, and clinical characteristics were gathered from survey measures and chart abstraction. Chi square and T-tests tested differences by ED utilization.
Results
UNASSIGNED
Participants (n=142) were 54.9% female and 68.8% Black, with an average age of 43.2 years (SD=12.5). Of the participants, 38.7% visited the ED in the study period, primarily for infectious or musculoskeletal causes. Participants with an ED visit were more likely to be Black (p=.011), have less social support (p=.030), more medical comorbidities (p=.008) including chronic pain (p=.045), and more visits with an addiction provider in the study period (p=.009).
Conclusions
UNASSIGNED
Factors associated with ED utilization among individuals receiving buprenorphine for OUD include low social support and medical comorbidities, including chronic pain. More research is needed on modifiable SDoH that influence ED utilization.
Identifiants
pubmed: 35783992
doi: 10.1016/j.dadr.2022.100062
pmc: PMC9248991
mid: NIHMS1816980
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : NIDA NIH HHS
ID : K23 DA053507
Pays : United States
Organisme : NIDA NIH HHS
ID : T32 DA007027
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002649
Pays : United States
Commentaires et corrections
Type : ErratumIn
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper
Références
Addiction. 2016 May;111(5):892-902
pubmed: 26662858
Health Aff (Millwood). 2016 Jan;35(1):12-9
pubmed: 26733696
Addiction. 2020 Jun;115(6):1011-1023
pubmed: 31705770
J Subst Abuse Treat. 2016 Aug;67:9-14
pubmed: 27296656
Am J Psychiatry. 2020 Feb 1;177(2):117-124
pubmed: 31786933
Anesthesiology. 2014 May;120(5):1262-74
pubmed: 24509068
Harm Reduct J. 2021 Oct 13;18(1):103
pubmed: 34645477
Drug Alcohol Depend. 2011 Jul 1;116(1-3):57-63
pubmed: 21237585
BMC Health Serv Res. 2016 Oct 20;16(1):594
pubmed: 27765045
J Pain. 2006 Nov;7(11):779-93
pubmed: 17074616
J Subst Abuse Treat. 2018 Aug;91:57-68
pubmed: 29910015
Popul Health Manag. 2014 Dec;17(6):372-87
pubmed: 25075734
JAMA Netw Open. 2020 Feb 5;3(2):e1920622
pubmed: 32022884
Subst Use Misuse. 2008;43(1):27-54
pubmed: 18189204
Psychiatr Q. 2017 Dec;88(4):721-732
pubmed: 28108941
Med Care. 2006 Jan;44(1):8-15
pubmed: 16365607
Subst Use Misuse. 2018 Nov 10;53(13):2265-2269
pubmed: 29671696
J Subst Abuse Treat. 2012 Dec;43(4):451-7
pubmed: 22534003
AMIA Annu Symp Proc. 2011;2011:409-16
pubmed: 22195094
PLoS One. 2016 Jan 19;11(1):e0147116
pubmed: 26784515
PLoS One. 2020 May 14;15(5):e0232086
pubmed: 32407321
Drug Alcohol Depend. 2015 Dec 1;157:143-9
pubmed: 26518253
Drug Alcohol Depend. 2020 Jul 1;212:107992
pubmed: 32388492
Psychol Serv. 2021 Dec 30;:
pubmed: 34968125
Soc Sci Med. 1991;32(6):705-14
pubmed: 2035047
J Racial Ethn Health Disparities. 2022 Aug;9(4):1557-1567
pubmed: 34254271
Am J Emerg Med. 2020 Sep;38(9):1904-1909
pubmed: 32739860
J Healthc Manag. 2013 Nov-Dec;58(6):412-27; discussion 428
pubmed: 24400457
J Subst Abuse Treat. 2019 Sep;104:135-143
pubmed: 31370977