TY - JOUR
AU - Y. Zhu
AU - L. M. Baldwin
AU - L. J. Mooney
AU - A. J. Saxon
AU - E. Kan
AU - Y. I. Hser
A1 - 
AB - BACKGROUND: Co-occurring substance use disorders (SUDs) among individuals with opioid use disorder (OUD) are associated with additional impairment, overdose, and death. This study examined characteristics of patients who have OUD with and without co-occurring SUDs in rural primary care clinics. METHODS: Secondary analysis used electronic health record (EHR) data from six rural primary care clinics, including demographics, diagnoses, encounters, and prescriptions of medication for OUD (MOUD), as well as EHR data from an external telemedicine vendor that provided MOUD to some clinic patients. The study population included all adult patients who had a visit to the participating clinics from October 2019 to January 2021. RESULTS: We identified 1164 patients with OUD; 72.6 % had OUD only, 11.5 % had OUD and stimulant use disorder (OUD + StUD), and 15.9 % had OUD and other non-stimulant substance use disorder (OUD + Other). The OUD + StUD group had the highest rates of hepatitis C virus (25.4 % for OUD + StUD, 17.8 % for OUD + Other, and 7.5 % for OUD Only; p < 0.001) and the highest rates of mental health disorders (78.4 %, 69.7 %, and 59.9 %, respectively; p < 0.001). Compared to the OUD Only group, patients in the OUD + StUD and OUD + Other groups were more likely to receive telehealth services provided by clinic staff, in-clinic behavioral health services, and in-clinic MOUD. The OUD + StUD group had the highest proportion of referrals to the external telemedicine vendor. CONCLUSIONS: More than 27 % of patients with OUD in rural primary care clinics had other co-occurring SUDs, and these patients received more healthcare services than those with OUD only. Future studies should examine variations in outcomes associated with these other services among patients with OUD and co-occurring SUDs.
AD - Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, United States of America.; Department of Family Medicine, University of Washington, Seattle, WA 98195, United States of America.; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, United States of America; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, United States of America.; Center of Excellence in Substance Addiction Treatment and Education, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, United States of America; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, United States of America.; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, United States of America. Electronic address: yhser@mednet.ucla.edu.
AN - 38097045
BT - J Subst Use Addict Treat
C5 - Opioids & Substance Use; Healthcare Disparities; HIT & Telehealth
DA - Mar
DO - 10.1016/j.josat.2023.209269
DP - NLM
ET - 20231212
JF - J Subst Use Addict Treat
LA - eng
N2 - BACKGROUND: Co-occurring substance use disorders (SUDs) among individuals with opioid use disorder (OUD) are associated with additional impairment, overdose, and death. This study examined characteristics of patients who have OUD with and without co-occurring SUDs in rural primary care clinics. METHODS: Secondary analysis used electronic health record (EHR) data from six rural primary care clinics, including demographics, diagnoses, encounters, and prescriptions of medication for OUD (MOUD), as well as EHR data from an external telemedicine vendor that provided MOUD to some clinic patients. The study population included all adult patients who had a visit to the participating clinics from October 2019 to January 2021. RESULTS: We identified 1164 patients with OUD; 72.6 % had OUD only, 11.5 % had OUD and stimulant use disorder (OUD + StUD), and 15.9 % had OUD and other non-stimulant substance use disorder (OUD + Other). The OUD + StUD group had the highest rates of hepatitis C virus (25.4 % for OUD + StUD, 17.8 % for OUD + Other, and 7.5 % for OUD Only; p < 0.001) and the highest rates of mental health disorders (78.4 %, 69.7 %, and 59.9 %, respectively; p < 0.001). Compared to the OUD Only group, patients in the OUD + StUD and OUD + Other groups were more likely to receive telehealth services provided by clinic staff, in-clinic behavioral health services, and in-clinic MOUD. The OUD + StUD group had the highest proportion of referrals to the external telemedicine vendor. CONCLUSIONS: More than 27 % of patients with OUD in rural primary care clinics had other co-occurring SUDs, and these patients received more healthcare services than those with OUD only. Future studies should examine variations in outcomes associated with these other services among patients with OUD and co-occurring SUDs.
PY - 2024
SN - 2949-8759
SP - 209269
ST - Co-occurring substance use disorders among patients with opioid use disorder in rural primary care clinics
T1 - Co-occurring substance use disorders among patients with opioid use disorder in rural primary care clinics
T2 - J Subst Use Addict Treat
TI - Co-occurring substance use disorders among patients with opioid use disorder in rural primary care clinics
U1 - Opioids & Substance Use; Healthcare Disparities; HIT & Telehealth
U3 - 10.1016/j.josat.2023.209269
VL - 158
VO - 2949-8759
Y1 - 2024
ER -