Optimally Choosing Medication Type for Patients With Opioid Use Disorder.
Am J Epidemiol
; 192(5): 748-756, 2023 05 05.
Article
en En
| MEDLINE
| ID: mdl-36549900
ABSTRACT
Patients with opioid use disorder (OUD) tend to get assigned to one of 3 medications based on the treatment program to which the patient presents (e.g., opioid treatment programs tend to treat patients with methadone, while office-based practices tend to prescribe buprenorphine). It is possible that optimally matching patients with treatment type would reduce the risk of return to regular opioid use (RROU). We analyzed data from 3 comparative effectiveness trials from the US National Institute on Drug Abuse Clinical Trials Network (CTN0027, 2006-2010; CTN0030, 2006-2009; and CTN0051 2014-2017), in which patients with OUD (n = 1,459) were assigned to treatment with either injection extended-release naltrexone (XR-NTX), sublingual buprenorphine-naloxone (BUP-NX), or oral methadone. We learned an individualized rule by which to assign medication type such that risk of RROU during 12 weeks of treatment would be minimized, and then estimated the amount by which RROU risk could be reduced if the rule were applied. Applying our estimated treatment rule would reduce risk of RROU compared with treating everyone with methadone (relative risk (RR) = 0.79, 95% confidence interval (CI) 0.60, 0.97) or treating everyone with XR-NTX (RR = 0.71, 95% CI 0.47, 0.96). Applying the estimated treatment rule would have resulted in a similar risk of RROU to that of with treating everyone with BUP-NX (RR = 0.92, 95% CI 0.73, 1.11).
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Buprenorfina
/
Trastornos Relacionados con Opioides
Tipo de estudio:
Etiology_studies
Límite:
Humans
Idioma:
En
Año:
2023
Tipo del documento:
Article