TY - JOUR
T1 - Medication-assisted treatment for substance use disorders within a national community health center research network
AU - Rieckmann, Traci
AU - Muench, John
AU - McBurnie, Mary Ann
AU - Leo, Michael C.
AU - Crawford, Phillip
AU - Ford, Daren
AU - Stubbs, Jennifer
AU - O’Cleirigh, Conall
AU - Mayer, Kenneth H.
AU - Fiscella, Kevin
AU - Wright, Nicole
AU - Doe-Simkins, Maya
AU - Cuddeback, Matthew
AU - Salisbury-Afshar, Elizabeth
AU - Nelson, Christine
N1 - Publisher Copyright:
© 2016 Taylor & Francis Group, LLC.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background: The Affordable Care Act increases access to treatment services for people who suffer from substance use disorders (SUDs), including alcohol use disorders (AUDs) and opioid use disorders (OUDs). This increased access to treatment has broad implications for delivering health services and creates a dramatic need for transformation in clinical care, service lines, and collaborative care models. Medication-assisted treatments (MAT) are effective for helping SUD patients reach better outcomes. This article uses electronic health record (EHR) data to examine the prevalence of EHR-documented SUDs, patient characteristics, and patterns of MAT prescribing and screening for patients within the Community Health Applied Research Network (CHARN), a national network of 17 community health centers that facilitates patient-centered outcomes research among underserved populations. Methods: Hierarchical generalized linear models examined patient characteristics, SUD occurrence rates, MAT prescription, and human immunodeficiency virus (HIV) and hepatitis virus C screening for patients with AUDs or OUDs. Results: Among 572,582 CHARN adult patients, 16,947 (3.0%) had a documented AUD diagnosis and 6,080 (1.1%) an OUD diagnosis. Alcohol MAT prescriptions were documented for 547 AUD patients (3.2%) and opioid MAT for 1,764 OUD patients (29.0%). Among OUD patients, opioid MAT was significantly associated with HIV screening (odds ratio [OR] = 1.31, P <.001) in OUD patients, as was alcohol MAT among AUD patients (OR = 1.30, P =.013). Conclusions: These findings suggest that effective opioid and alcohol MAT may be substantially underprescribed among safety-net patients identified as having OUDs or AUDs.
AB - Background: The Affordable Care Act increases access to treatment services for people who suffer from substance use disorders (SUDs), including alcohol use disorders (AUDs) and opioid use disorders (OUDs). This increased access to treatment has broad implications for delivering health services and creates a dramatic need for transformation in clinical care, service lines, and collaborative care models. Medication-assisted treatments (MAT) are effective for helping SUD patients reach better outcomes. This article uses electronic health record (EHR) data to examine the prevalence of EHR-documented SUDs, patient characteristics, and patterns of MAT prescribing and screening for patients within the Community Health Applied Research Network (CHARN), a national network of 17 community health centers that facilitates patient-centered outcomes research among underserved populations. Methods: Hierarchical generalized linear models examined patient characteristics, SUD occurrence rates, MAT prescription, and human immunodeficiency virus (HIV) and hepatitis virus C screening for patients with AUDs or OUDs. Results: Among 572,582 CHARN adult patients, 16,947 (3.0%) had a documented AUD diagnosis and 6,080 (1.1%) an OUD diagnosis. Alcohol MAT prescriptions were documented for 547 AUD patients (3.2%) and opioid MAT for 1,764 OUD patients (29.0%). Among OUD patients, opioid MAT was significantly associated with HIV screening (odds ratio [OR] = 1.31, P <.001) in OUD patients, as was alcohol MAT among AUD patients (OR = 1.30, P =.013). Conclusions: These findings suggest that effective opioid and alcohol MAT may be substantially underprescribed among safety-net patients identified as having OUDs or AUDs.
KW - Community health centers
KW - medication-assisted treatment
KW - substance use disorders
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UR - http://www.scopus.com/inward/citedby.url?scp=84995543610&partnerID=8YFLogxK
U2 - 10.1080/08897077.2016.1189477
DO - 10.1080/08897077.2016.1189477
M3 - Article
C2 - 27218678
AN - SCOPUS:84995543610
SN - 0889-7077
VL - 37
SP - 625
EP - 634
JO - Substance Abuse
JF - Substance Abuse
IS - 4
ER -