TY - JOUR
AU - H. Pham
AU - A. Ober
AU - L. M. Baldwin
AU - L. J. Mooney
AU - Y. Zhu
AU - Z. Fei
AU - Y. I. Hser
A1 - 
AB - OBJECTIVES: Factors associated with treatment retention on medications for opioid use disorder (MOUD) in rural settings are poorly understood. This study examines associations between social determinants of health (SDoH) and MOUD retention among patients with opioid use disorder (OUD) in rural primary care settings. METHODS: We analyzed patient electronic health records from 6 rural clinics. Participants (N = 575) were adult patients with OUD and had any prescription for MOUD from October 2019 to April 2020. MOUD retention was measured by MOUD days and continuity defined as continuous 180 MOUD days with no more than a 7-day gap. Mixed-effect regressions assessed associations between the outcomes and SDoH (Medicaid insurance, social deprivation index [SDI], driving time from home to the clinic), telehealth use, and other covariates. RESULTS: Mean patient MOUD days were 127 days (SD = 50.7 days). Living in more disadvantaged areas (based on SDI) (adjusted relative risk [aRR]: 0.98; 95% confidence interval [CI], 0.98-0.99) and having more than an hour (compared with an hour or less) driving time from home to clinic (aRR: 0.95; 95% CI, 0.93-0.97) were associated with fewer MOUD days. Using telehealth was associated with more MOUD days (aRR: 1.23; 95% CI, 1.21-1.26). In this cohort, 21.7% of the participants were retained on MOUD for at least 180 days. SDoH and use of telehealth were not associated with having continuity of MOUD. CONCLUSIONS: Addressing SDoH (eg, SDI) and providing telehealth (eg, improvements in public transportation, internet access) may improve MOUD days in rural settings.
AD - From the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA (HP, LJM, YZ, Y-IH); RAND Corporation, Santa Monica, CA (AO); Department of Family Medicine, University of Washington, Seattle, WA (L-MB); VA Greater Los Angeles Healthcare System, Los Angeles, CA (LJM); and Department of Statistics, University of California Riverside, Riverside, CA (ZF).
AN - 38315721
BT - J Addict Med
C5 - Opioids & Substance Use; HIT & Telehealth; Healthcare Disparities
DA - Feb 5
DO - 10.1097/adm.0000000000001274
DP - NLM
ET - 20240205
JF - J Addict Med
LA - eng
N2 - OBJECTIVES: Factors associated with treatment retention on medications for opioid use disorder (MOUD) in rural settings are poorly understood. This study examines associations between social determinants of health (SDoH) and MOUD retention among patients with opioid use disorder (OUD) in rural primary care settings. METHODS: We analyzed patient electronic health records from 6 rural clinics. Participants (N = 575) were adult patients with OUD and had any prescription for MOUD from October 2019 to April 2020. MOUD retention was measured by MOUD days and continuity defined as continuous 180 MOUD days with no more than a 7-day gap. Mixed-effect regressions assessed associations between the outcomes and SDoH (Medicaid insurance, social deprivation index [SDI], driving time from home to the clinic), telehealth use, and other covariates. RESULTS: Mean patient MOUD days were 127 days (SD = 50.7 days). Living in more disadvantaged areas (based on SDI) (adjusted relative risk [aRR]: 0.98; 95% confidence interval [CI], 0.98-0.99) and having more than an hour (compared with an hour or less) driving time from home to clinic (aRR: 0.95; 95% CI, 0.93-0.97) were associated with fewer MOUD days. Using telehealth was associated with more MOUD days (aRR: 1.23; 95% CI, 1.21-1.26). In this cohort, 21.7% of the participants were retained on MOUD for at least 180 days. SDoH and use of telehealth were not associated with having continuity of MOUD. CONCLUSIONS: Addressing SDoH (eg, SDI) and providing telehealth (eg, improvements in public transportation, internet access) may improve MOUD days in rural settings.
PY - 2024
SN - 1932-0620
ST - Social Determinants of Health and Continuity of Medications for Opioid Use Disorder Among Patients Receiving Treatment in Rural Primary Care Settings
T1 - Social Determinants of Health and Continuity of Medications for Opioid Use Disorder Among Patients Receiving Treatment in Rural Primary Care Settings
T2 - J Addict Med
TI - Social Determinants of Health and Continuity of Medications for Opioid Use Disorder Among Patients Receiving Treatment in Rural Primary Care Settings
U1 - Opioids & Substance Use; HIT & Telehealth; Healthcare Disparities
U3 - 10.1097/adm.0000000000001274
VO - 1932-0620
Y1 - 2024
ER -