scholarly journals Real-world changes in US health system hospital-based services following treatment with a prescription digital therapeutic for opioid use disorder

2021 ◽  
Author(s):  
Fulton F Velez ◽  
Sam Colman ◽  
Laura Kauffman ◽  
Kathryn Anastassopoulos ◽  
Sean Murphy ◽  
...  
Keyword(s):  
Health System ◽  
Real World ◽  
Opioid Use Disorder ◽  
Opioid Use

scholarly journals Real-world evidence for a prescription digital therapeutic to treat opioid use disorder

2020 ◽  
pp. 1-9
Author(s):  
Yuri A. Maricich ◽  
Xiaorui Xiong ◽  
Robert Gerwien ◽  
Alice Kuo ◽  
Fulton Velez ◽  
...  
Keyword(s):  
Real World ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Real World Evidence

scholarly journals Hepatitis C Treatment Among People Who Use Drugs in an Office-Based Opioid Treatment Program Versus a Syringe Exchange Program: A Real-World Prospective Clinical Trial

2021 ◽  
Vol 21 (8) ◽  
Author(s):  
Andrew Seaman ◽  
Wren Ronan ◽  
Lauren Myers ◽  
Haven Wheelock ◽  
Melinda Butler ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Treatment Outcomes ◽  
Real World ◽  
Treatment Completion ◽  
Opioid Use Disorder ◽  
People Who Use Drugs ◽  
Opioid Use ◽  
Hcv Treatment ◽  
Treatment Access ◽  
Open Label

Background: Hepatitis C Virus (HCV) treatment in people who inject drugs (PWID) is a key component of elimination models but PWID face substantial barriers to treatment access. Despite data showing treatment outcomes among PWID on medications for opioid use disorder (MOUD) are similar to non-PWID outcomes, few studies examine PWID treatment outcomes with only syringe services support. Objectives: To evaluate the effect of recruitment for HCV treatment with elbasvir/grazoprevir (E/G) in a syringe services program (SSP) as compared to an MOUD program for people with opioid use disorder. Methods: This real-world, multi-site prospective open-label pilot study compares treatment of PWID with aspartate aminotransferase to platelet ratio (APRI) < 0.7 and genotype 1a, 1b, and 4 HCV with E/G, engaged in MOUD (n = 25) or an SSP (n = 25). The MOUD arm was enrolled through a federally qualified community health center and SSP arm through a nearby SSP. Prospective arms were compared to an academic hepatology clinic group (n = 50). Sustained virologic response at 12 weeks (SVR12), medication adherence, and treatment discontinuation were evaluated. Results: In the MOUD vs SSP arms, substance use throughout treatment was found in 36% (9/25) vs 100% (25/25); good adherence (> 90% pills taken) in 100% (25/25) vs 68% (17/25); treatment completion 100% (25/25) vs 64% (16/25); and SVR12 rates were 96% (24/25) vs 60% (15/25). In the community standard comparison group, SVR12 was achieved in 94% (47/50). There were two virologic failures or re-infections in the SSP group; all other non-responders were due to missing SVR12 data. Conclusions: While recruitment and follow-up are challenging in SSPs, preliminary data suggests adherence, treatment completion, and SVR12 are high in PWID treated with E/G engaging in SSP or MOUD. All metrics are comparable to community standards for non-PWID for treatment of HCV with direct-antiviral drugs.

scholarly journals Association of opioid use disorder with healthcare utilization and cost in a public health system

2021 ◽  
Author(s):  
Oren Miron ◽  
Noam Barda ◽  
Ran Balicer ◽  
Ariel Kor ◽  
Shaul Lev-Ran
Keyword(s):  
Public Health ◽  
Health System ◽  
Healthcare Cost ◽  
Healthcare Costs ◽  
Public Health System ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Public Healthcare ◽  
Opioid Use ◽  
Cost Difference

Background and objectives: To quantify the healthcare costs associated with opioid use disorder among members in a public healthcare system, and compare them to healthcare costs in the general population. Methods: Retrospective cohort study in inpatient and outpatient care settings of Israel's largest public healthcare provider (that covers 4.7 million members). Participants included 1,173 members who had a diagnosis of opioid use disorder in the years between 2013 and 2018. Each patient was matched with 10 controls based on age and sex. The main outcome was monthly healthcare costs. Results: The mean monthly healthcare cost of members with opioid use disorder was $1,102 compared to $211 among controls (5.2-fold difference; 95% confidence interval [CI]: 4.6-6.0). After excluding members with heroin related diagnoses before the index date (in order to focus on prescription opioids), this healthcare cost ratio did not substantially change (4.6-fold; 95%-CI: 3.9-5.4). Members with opioid use disorder under the age of 65 years had a cost difference of 6.1-fold (95%-CI: 5.2-7.1), while those 65 years and older experienced cost difference of 3.4-fold (95%-CI: 2.6-4.5). The category with the highest cost for members with opioid use disorder was inpatient services, which was 8.7-fold (95%-CI 7.2-10.4) greater than among controls. Conclusions: Healthcare costs among individuals with opioid use disorder in a public health system were substantially higher than among controls, at least partially attributed to prescription opioid use disorder. Differences were greater among individuals younger than 65 years, highlighting the importance of preventing and treating opioid use disorder among younger adult populations.

scholarly journals Identifying Clinical Risk Factors for Opioid Use Disorder using a Distributed Algorithm to Combine Real-World Data from a Large Clinical Data Research Network

2020 ◽  
Author(s):  
Jiayi Tong ◽  
Zhaoyi Chen ◽  
Rui Duan ◽  
Wei-Hsuan Lo-Ciganic ◽  
Tianchen Lyu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Data ◽  
Real World ◽  
Distributed Algorithm ◽  
Opioid Use Disorder ◽  
Research Network ◽  
Patient Privacy ◽  
Opioid Use ◽  
Real World Data ◽  
Level Data

Because they contain detailed individual-level data on various patient characteristics including their medical conditions and treatment histories, electronic health record (EHR) systems have been widely adopted as an efficient source for health research. Compared to data from a single health system, real-world data (RWD) from multiple clinical sites provide a larger and more generalizable population for accurate estimation, leading to better decision making for health care. However, due to concerns over protecting patient privacy, it is challenging to share individual patient-level data across sites in practice. To tackle this issue, many distributed algorithms have been developed to transfer summary-level statistics to derive accurate estimates. Nevertheless, many of these algorithms require multiple rounds of communication to exchange intermediate results across different sites. Among them, the One-shot Distributed Algorithm for Logistic regression (termed ODAL) was developed to reduce communication overhead while protecting patient privacy. In this paper, we applied the ODAL algorithm to RWD from a large clinical data research network-the OneFlorida Clinical Research Consortium and estimated the associations between risk factors and the diagnosis of opioid use disorder (OUD) among individuals who received at least one opioid prescription. The ODAL algorithm provided consistent findings of the associated risk factors and yielded better estimates than meta- analysis.

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