Clinical outcomes and health care costs among people entering a safer opioid supply program in Ontario.

BACKGROUND

London InterCommunity Health Centre (LIHC) launched a safer opioid supply (SOS) program in 2016, where clients are prescribed pharmaceutical opioids and provided with comprehensive health and social supports. We sought to evaluate the impact of this program on health services utilization and health care costs.

METHODS

We conducted an interrupted time series analysis of London, Ontario, residents who received a diagnosis of opioid use disorder (OUD) and who entered the SOS program between January 2016 and March 2019, and a comparison group of individuals matched on demographic and clinical characteristics who were not exposed to the program. Primary outcomes were emergency department (ED) visits, hospital admissions, admissions for infections and health care costs. We used autoregressive integrated moving average (ARIMA) models to evaluate the impact of SOS initiation and compared outcome rates in the year before and after cohort entry.

RESULTS

In the time series analysis, rates of ED visits (-14 visits/100, 95% confidence interval [CI] -26 to -2;

INTERPRETATION

Although additional research is needed, this preliminary evidence indicates that SOS programs can play an important role in the expansion of treatment and harm-reduction options available to assist people who use drugs and who are at high risk of drug poisoning.

Informations de copyright

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Déclaration de conflit d'intérêts

Competing interests: Tara Gomes reports receiving grants paid to support the research program from the Ontario Ministry of Health, a grant paid to support the conduct of the study from the Canadian Institutes of Health Research (CIHR) and Canada Research Chair funding for salary support. Andrea Sereda is the medical lead in the Safer Opioid Supply program based out of the London InterCommunity Health Centre (LIHC). Dr. Sereda has also received support for attending meetings or travel from the LIHC (as an employee). Gillian Kolla is supported by a Banting postdoctoral fellowship from the CIHR and a postdoctoral fellowship from the Canadian Network on Hepatitis C. Separate from this study, Dr. Kolla received funding from LIHC’s Substance Use and Addictions Program grant to conduct an independent preliminary evaluation of the Safer Opioid Supply program. No other competing interests were declared.