PMH53 A Machine Learning Approach to Understanding How Patient Engagement with a Prescription Digital Therapeutic Relates to Healthcare Resource Utilization in Opioid Use Disorder

2021 ◽  
Vol 24 ◽  
pp. S137
Author(s):  
H.M. Shapiro ◽  
R.W. Gerwien ◽  
F. Velez
2021 ◽  
Vol Volume 13 ◽  
pp. 909-916
Author(s):  
Fulton F Velez ◽  
Sam Colman ◽  
Laura Kauffman ◽  
Charles Ruetsch ◽  
Kathryn Anastassopoulos ◽  
...  

2021 ◽  
Vol 93 (6) ◽  
pp. AB167
Author(s):  
Ishani Shah ◽  
Nicholas M. McDonald ◽  
Shifa Umar ◽  
Vaibhav Wadhwa ◽  
Saurabh Chandan ◽  
...  

2019 ◽  
Author(s):  
Jiayi W. Cox ◽  
Richard M. Sherva ◽  
Kathryn L. Lunetta ◽  
Richard Saitz ◽  
Mark Kon ◽  
...  

AbstractBackground and AimsPeople with opioid use disorder (OUD) can stop using opioids on their own, with help from groups and with treatment, but there is limited research on the factors that influence opioid cessation.MethodsWe employed multiple machine learning prediction algorithms (LASSO, random forest, deep neural network, and support vector machine) to assess factors associated with ceasing opioid use in a sample comprised of African Americans (AAs) and European Americans (EAs) who met DSM-5 criteria for mild to severe OUD. Values for several thousand demographic, alcohol and other drug use, general health, and behavioral variables, as well as diagnoses for other psychiatric disorders, were obtained for each participant from a detailed semi-structured interview.ResultsSupport vector machine models performed marginally better on average than those derived using other machine learning methods with maximum prediction accuracies of 75.4% in AAs and 79.4% in EAs. Subsequent stepwise regression analyses that considered the 83 most highly ranked variables across all methods and models identified less recent cocaine use (p<5×10−8), a shorter duration of opioid use (p<5×10−6), and older age (p<5×10−9) as the strongest independent predictors of opioid cessation. Factors related to drug use comprised about half of the significant independent predictors, with other predictors related to non-drug use behaviors, psychiatric disorders, overall health, and demographics.ConclusionsThese proof-of-concept findings provide information that can help develop strategies for improving OUD management and the methods we applied provide a framework for personalizing OUD treatment.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258545
Author(s):  
G. Craig Wood ◽  
Lisa Bailey-Davis ◽  
Peter Benotti ◽  
Adam Cook ◽  
James Dove ◽  
...  

Objective Determine the impact of long-term non-surgical weight loss maintenance on clinical relevance for osteoarthritis, cancer, opioid use, and depression/anxiety and healthcare resource utilization. Methods A cohort of adults receiving primary care within Geisinger Health System between 2001–2017 was retrospectively studied. Patients with ≥3 weight measurements in the two-year index period and obesity at baseline (BMI ≥30 kg/m2) were categorized: Obesity Maintainers (reference group) maintained weight within +/-3%; Weight Loss Rebounders lost ≥5% body weight in year one, regaining ≥20% of weight loss in year two; Weight Loss Maintainers lost ≥5% body weight in year one, maintaining ≥80% of weight loss. Association with development of osteoarthritis, cancer, opioid use, and depression/anxiety, was assessed; healthcare resource utilization was quantified. Magnitude of weight loss among maintainers was evaluated for impact on health outcomes. Results In total, 63,567 patients were analyzed including 67% Obesity Maintainers, 19% Weight Loss Rebounders, and 14% Weight Loss Maintainers; median follow-up was 9.7 years. Time until osteoarthritis onset was delayed for Weight Loss Maintainers compared to Obesity Maintainers (Logrank test p <0.0001). Female Weight Loss Maintainers had a 19% and 24% lower risk of developing any cancer (p = 0.0022) or obesity-related cancer (p = 0.0021), respectively. No significant trends were observed for opioid use. Weight loss Rebounders and Maintainers had increased risk (14% and 25%) of future treatment for anxiety/depression (both <0.0001). Weight loss maintenance of >15% weight loss was associated with the greatest decrease in incident osteoarthritis. Healthcare resource utilization was significantly higher for Weight Loss Rebounders and Maintainers compared to Obesity Maintainers. Increased weight loss among Weight Loss Maintainers trended with lower overall healthcare resource utilization, except for hospitalizations. Conclusions In people with obesity, sustained weight loss was associated with greater clinical benefits than regained short-term weight loss and obesity maintenance. Higher weight loss magnitudes were associated with delayed onset of osteoarthritis and led to decreased healthcare utilization.


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