Population‐level impact of initiating pharmacotherapy and linking to care people with opioid use disorder at inpatient medically managed withdrawal programs: an effectiveness and cost‐effectiveness analysis.
Background and Aims: Medications for opioid use disorder (MOUD) are shown to reduce opioid use and the risk of overdose. People with opioid use disorder (OUD) who exit inpatient medically managed withdrawal programs (detox) without initiating MOUD and linking to outpatient care have high rates of ov...
| Publicado en: | Addiction Vol. 117; no. 9; pp. 2450 - 2462 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Sep2022
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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=158316587&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 158316587 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Sep2022 vid: 117 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 158316587 156260422 158316587 158316587 10.1111/add.15879 158316587 ppf: 2450 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Population‐level impact of initiating pharmacotherapy and linking to care people with opioid use disorder at inpatient medically managed withdrawal programs: an effectiveness and cost‐effectiveness analysis. aug: au: Savinkina, Alexandra Madushani, Rajapaksha W.M.A. Eftekhari Yazdi, Golnaz Wang, Jianing Barocas, Joshua A. Morgan, Jake R. Assoumou, Sabrina A. Walley, Alexander Y. Linas, Benjamin P. Murphy, Sean M. affil: Section of Infectious Diseases, Boston Medical Center (BMC), Boston MA,, USA sug: subj: Narcotics Substance Use Disorders Drug Therapy Opiate Overdose Risk Factors Detoxification, Alternative Therapy Cost Benefit Analysis Program Evaluation Opiate Overdose Mortality Human Simulations Patient Care Standards Comparative Studies Confidence Intervals Quality-Adjusted Life Years Massachusetts ab: Background and Aims: Medications for opioid use disorder (MOUD) are shown to reduce opioid use and the risk of overdose. People with opioid use disorder (OUD) who exit inpatient medically managed withdrawal programs (detox) without initiating MOUD and linking to outpatient care have high rates of overdose. While detox encounters provide a theoretical opportunity for MOUD initiation, this is not ubiquitous in the United States. We used simulation modeling to estimate the population‐level health effects and cost‐effectiveness of a policy encouraging MOUD initiation during inpatient detox encounters. Design, Setting and Participants: We employed a dynamic population state‐transition model to evaluate the effectiveness and cost‐effectiveness of using detox programs as venues for initiating MOUD in Massachusetts, United States. We compared standard of care, where no detox patients initiate MOUD or link to outpatient MOUD providers, to strategies of offering MOUD to detox patients and linking those patients to outpatient MOUD. Measures: Budgetary impact to the Massachusetts health‐care sector, incremental cost‐effectiveness ratios (ICER) and total counts and percentage differences of fatal overdoses prevented. Findings: Initiating MOUD in detox with perfect linkage to outpatient MOUD would reduce fatal overdoses by 4.5% [95% confidence interval (CI) = 2.3–5.9], at an ICER of $56 000 per quality‐adjusted life‐year (QALY) gained, compared with the standard of care. With moderate linkage, fatal overdoses would be reduced by 2.3% (95% CI= 1.2–3.1) with an ICER of $78 500 per QALY gained, compared with standard of care. Budgetary increase to Massachusetts health‐care spending ranged from 0.5–1%. Conclusion: A simulation model indicates that initiation of medications for opioid use disorder and linkage policies among detox patients in Massachusetts, USA could prevent fatal opioid overdoses in the opioid use disorder population and would be cost‐effective from a health‐care sector perspective. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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