E-003 - ASSESSMENT OF TREATMENT PATHS FOR OUD PATIENTS AFTER AN ACUTE OUD EVENT.
Thursday, March 23, 2023
5:00 PM – 6:30 PM EDT
R. Halpern1, W. Mullen2, S. Gaiazov2, L. Le1, C. Landis1, A. Wheeler2; 1Optum, Eden Prairie, MN, United States, 2Indivior, North Chesterfield, VA, United States.
Senior RWE Research Scientist Indivior North Chesterfield, Virginia, United States
Background: Emergency departments (EDs) can play a vital role in the US opioid epidemic by referring opioid use disorder (OUD) patients for medications for opioid use disorder (MOUD) and clinical services. This study examined treatment paths after acute opioid events.
Methods: This retrospective cross-sectional US claims data analysis examined adult commercially insured patients with an acute OUD (index) event from Jul 2016 - Feb 2019. Post-index period was divided into 5 intervals: 1 month, 2-3, 4-6, 7-9, and 10-12-months after index event. In each interval, indicators for ≥1 buprenorphine (BUP) claim and ≥1 claim for substance use or behavioral health services were measured. “Consistent” treatment paths were (1) ≥1 BUP + ≥1 service, (2) ≥1 BUP + no service, (3) no BUP + ≥1 service, or (4) no BUP + no service across all intervals. “Inconsistent” treatment paths had BUP and/or services that varied across intervals.
Results: The final sample was 6,143 patients. Index events were 50% ED, 47% inpatient, 3% both venues. Post-index treatment was inconsistent for 54% of patients, and consistent for the remaining 46%, for whom 5% had ≥1 claim for BUP, 14% had no BUP + ≥1 service and 27% had no BUP + no services. In the full sample regardless of treatment path, 48% did not receive BUP or any services during the first 30 days post-index. Patients with ED index events were less likely to receive BUP and/or services within the first 30 days.
Conclusion: Despite extensive evidence on BUP effectiveness, only 5% of the patients had consistent treatment with BUP. This represents a missed opportunity in the treatment of patients who experienced an acute OUD event and need appropriate guidance for treatment. These findings highlight opportunities to address patient barriers to receiving MOUD.
Centers for Disease Control and Prevention (CDC). National Center for Injury Prevention and Control. CDC Vital Signs: Opioid overdoses treated in emergency departments: Identify opportunities for action. https://www.cdc.gov/vitalsigns/pdf/2018-03-vitalsigns.pdf (2018). Accessed 01 March 2022.
