Real‐world effectiveness of pharmacological treatments of opioid use disorder in a national cohort.
Aim: To investigate the real‐world effectiveness of pharmacological treatments (buprenorphine, methadone) of opioid use disorder (OUD). Design A nation‐wide, register‐based cohort study. Setting: Sweden. Participants: All residents aged 16–64 years living in Sweden using OUD medication from July 200...
| Publicado en: | Addiction Vol. 117; no. 6; pp. 1683 - 1692 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156737799&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156737799 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Jun2022 vid: 117 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 156737799 155099394 156737799 156737799 10.1111/add.15814 156737799 ppf: 1683 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Real‐world effectiveness of pharmacological treatments of opioid use disorder in a national cohort. aug: au: Heikkinen, Milja Taipale, Heidi Tanskanen, Antti Mittendorfer‐Rutz, Ellenor Lähteenvuo, Markku Tiihonen, Jari affil: Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland sug: subj: Narcotics Adverse Effects Substance Use Disorders Drug Therapy Buprenorphine Therapeutic Use Methadone Therapeutic Use Drug Efficacy Evaluation Human Prospective Studies Sweden Persons with Substance Use Disorders Adolescence Young Adult Adult Middle Age Male Female Descriptive Statistics Drugs, Prescription Inpatients Outpatients Cause of Death Sick Leave Persons with Disabilities Pensions Hospitalization Substance Use Disorders Mortality Cox Proportional Hazards Model Multiple Regression Confidence Intervals Risk Assessment Death Risk Factors Comparative Studies Nonexperimental Studies Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Aim: To investigate the real‐world effectiveness of pharmacological treatments (buprenorphine, methadone) of opioid use disorder (OUD). Design A nation‐wide, register‐based cohort study. Setting: Sweden. Participants: All residents aged 16–64 years living in Sweden using OUD medication from July 2005 to December 2016 (n = 5757, 71.8% men) were identified from registers of prescriptions, inpatient and specialized outpatient care, causes of death, sickness absence and disability pensions. Measurements Main outcome: hospitalization due to OUD. Secondary outcomes: hospitalization due to any cause; death due to all, natural and external causes. Mortality was analyzed with between‐individual multivariate‐adjusted Cox hazards regression model. Recurrent outcomes, such as hospitalizations, were analyzed with within‐individual analyses to eliminate selection bias. OUD medication use versus non‐use was modelled with PRE2DUP (from prescription drug purchases to drug use periods) method. Findings Buprenorphine [hazard ratio (HR) = 0.73, 95% confidence interval (CI) = 0.54–0.97] and methadone (HR = 0.74, 95% CI = 0.59–0.93) use were associated with significantly lower risk of OUD hospitalization, but not any‐cause hospitalizations, compared with the time‐periods when the same individual did not use OUD medication. The use of buprenorphine and methadone were both associated with significantly lower risk of all‐cause mortality (HR = 0.45, 95% CI = 0.34–0.59; HR = 0.51, 95% CI = 0.41–0.63, respectively), compared with non‐use of both medications. Similar results were found for risk of mortality due to external causes (HR = 0.39; 95% CI = 0.27–0.54; HR = 0.40; 95% CI = 0.29–0.53, respectively), but not for mortality due to natural causes. The risk of OUD hospitalization and all‐cause mortality was decreased in all duration categories of studied medications (< 30, 31–180, 181–365 and >365 days), except for methadone use less than 30 days. Conclusions: The use of buprenorphine and methadone are both associated with a significantly lower risk of hospitalization due to opioid use disorder and death due to all and external causes, when compared with non‐use. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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