Medication-assisted treatment for substance use disorders within a national community health center research network

Traci Rieckmann, John Muench, Mary Ann McBurnie, Michael C. Leo, Phillip Crawford, Daren Ford, Jennifer Stubbs, Conall O’Cleirigh, Kenneth H. Mayer, Kevin Fiscella, Nicole Wright, Maya Doe-Simkins, Matthew Cuddeback, Elizabeth Salisbury-Afshar, Christine Nelson

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)625-634
Number of pages10
JournalSubstance Abuse
Volume37
Issue number4
DOIs
StatePublished - Oct 1 2016

Fingerprint

Community Health Centers
Substance-Related Disorders
Opioid Analgesics
Alcohols
Research
Therapeutics
Electronic Health Records
Prescriptions
Patient Outcome Assessment
Odds Ratio
HIV
Patient Protection and Affordable Care Act
Health
Vulnerable Populations
Patient Safety
Hepacivirus
Health Services
Linear Models

Keywords

  • Community health centers
  • medication-assisted treatment
  • substance use disorders

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

Cite this

Medication-assisted treatment for substance use disorders within a national community health center research network. / Rieckmann, Traci; Muench, John; McBurnie, Mary Ann; Leo, Michael C.; Crawford, Phillip; Ford, Daren; Stubbs, Jennifer; O’Cleirigh, Conall; Mayer, Kenneth H.; Fiscella, Kevin; Wright, Nicole; Doe-Simkins, Maya; Cuddeback, Matthew; Salisbury-Afshar, Elizabeth; Nelson, Christine.

In: Substance Abuse, Vol. 37, No. 4, 01.10.2016, p. 625-634.

Research output: Contribution to journalArticle

Rieckmann, T, Muench, J, McBurnie, MA, Leo, MC, Crawford, P, Ford, D, Stubbs, J, O’Cleirigh, C, Mayer, KH, Fiscella, K, Wright, N, Doe-Simkins, M, Cuddeback, M, Salisbury-Afshar, E & Nelson, C 2016, 'Medication-assisted treatment for substance use disorders within a national community health center research network', Substance Abuse, vol. 37, no. 4, pp. 625-634. https://doi.org/10.1080/08897077.2016.1189477
Rieckmann, Traci ; Muench, John ; McBurnie, Mary Ann ; Leo, Michael C. ; Crawford, Phillip ; Ford, Daren ; Stubbs, Jennifer ; O’Cleirigh, Conall ; Mayer, Kenneth H. ; Fiscella, Kevin ; Wright, Nicole ; Doe-Simkins, Maya ; Cuddeback, Matthew ; Salisbury-Afshar, Elizabeth ; Nelson, Christine. / Medication-assisted treatment for substance use disorders within a national community health center research network. In: Substance Abuse. 2016 ; Vol. 37, No. 4. pp. 625-634.
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