TY - JOUR
KW - Methamphetamine
KW - medical utilization
KW - mirror-image study
KW - psychiatric comorbidity
AU - W. C. Lee
AU - H. M. Chang
AU - M. C. Huang
AU - C. H. Pan
AU - S. S. Su
AU - S . Y. Tsai
AU - C. C. Chen
AU - C. J. Kuo
A1 - 
AB - BACKGROUND: Evidence of patterns of medical utilization and distribution of comorbidities among individuals using methamphetamine remains limited. OBJECTIVE: This study aims to investigate changes in medical utilization and comorbidities before and after a diagnosis of methamphetamine use disorder. METHODS: A total of 3321 cases (79% were male) of methamphetamine use disorder between January 1, 1996, and December 31, 2012, were identified from Psychiatric Inpatient Medical Claims database in Taiwan. Information was collected on demographics, diagnoses, and medical utilizations. The date of newly diagnosed with methamphetamine use disorder was defined as the baseline. Mirror-image study design was used to compare changes in medical utilization and comorbidities between the pre-baseline period (within 1 year before diagnosis) and the post-baseline period (within 1 year after diagnosis). Conditional logistic regression was used to estimate changes in medical utilization and comorbidities. RESULTS: Most cases (77%) were first identified in a psychiatric department. There is a significant increase (P < .001) in psychiatric admission (odds ratio[OR] = 2.19), psychiatric emergency visits (OR = 1.31), and psychiatric outpatient visits (OR = 1.15) after diagnosis. Multivariable analysis revealed significantly increased risks (P < .001) of non-methamphetamine drug induced mental disorders (adjusted OR[aOR] = 29.47), schizophrenia (aOR = 2.62), bipolar disorder (aOR = 2.14), organic mental disorder (aOR = 1.82), and upper respiratory tract infection (aOR = 2.03) after diagnosis. CONCLUSIONS: We found significant increases of medical utilization and psychiatric comorbidities after diagnosed with methamphetamine use disorder. These findings may reflect the problem of delayed diagnosis and treatment. Enhancement of early identification of methamphetamine use disorder in general practice is required for early intervention and decreased subsequent morbidities.
AD - Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.; Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.; Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.; Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.; Department of Psychology, National Chengchi University, Taipei, Taiwan.; Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.; Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.; Department of Psychiatry, Mackay Medical College, Taipei, Taiwan.; Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
BT - The American Journal of Drug and Alcohol Abuse
C5 - Financing & Sustainability; Healthcare Disparities; Opioids & Substance Use
CY - England
DO - 10.1080/00952990.2021.1979990
JF - The American Journal of Drug and Alcohol Abuse
LA - eng
M1 - Journal Article
N2 - BACKGROUND: Evidence of patterns of medical utilization and distribution of comorbidities among individuals using methamphetamine remains limited. OBJECTIVE: This study aims to investigate changes in medical utilization and comorbidities before and after a diagnosis of methamphetamine use disorder. METHODS: A total of 3321 cases (79% were male) of methamphetamine use disorder between January 1, 1996, and December 31, 2012, were identified from Psychiatric Inpatient Medical Claims database in Taiwan. Information was collected on demographics, diagnoses, and medical utilizations. The date of newly diagnosed with methamphetamine use disorder was defined as the baseline. Mirror-image study design was used to compare changes in medical utilization and comorbidities between the pre-baseline period (within 1 year before diagnosis) and the post-baseline period (within 1 year after diagnosis). Conditional logistic regression was used to estimate changes in medical utilization and comorbidities. RESULTS: Most cases (77%) were first identified in a psychiatric department. There is a significant increase (P < .001) in psychiatric admission (odds ratio[OR] = 2.19), psychiatric emergency visits (OR = 1.31), and psychiatric outpatient visits (OR = 1.15) after diagnosis. Multivariable analysis revealed significantly increased risks (P < .001) of non-methamphetamine drug induced mental disorders (adjusted OR[aOR] = 29.47), schizophrenia (aOR = 2.62), bipolar disorder (aOR = 2.14), organic mental disorder (aOR = 1.82), and upper respiratory tract infection (aOR = 2.03) after diagnosis. CONCLUSIONS: We found significant increases of medical utilization and psychiatric comorbidities after diagnosed with methamphetamine use disorder. These findings may reflect the problem of delayed diagnosis and treatment. Enhancement of early identification of methamphetamine use disorder in general practice is required for early intervention and decreased subsequent morbidities.
PP - England
PY - 2021
SN - 1097-9891; 0095-2990
SP - 1
EP - 10
EP - 
T1 - Increased medical utilization and psychiatric comorbidity following a new diagnosis of methamphetamine use disorder
T2 - The American Journal of Drug and Alcohol Abuse
TI - Increased medical utilization and psychiatric comorbidity following a new diagnosis of methamphetamine use disorder
U1 - Financing & Sustainability; Healthcare Disparities; Opioids & Substance Use
U2 - 34670448
U3 - 10.1080/00952990.2021.1979990
VO - 1097-9891; 0095-2990
Y1 - 2021
Y2 - Oct 20
ER -