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Predictors of medication-assisted treatment initiation for opioid use disorder in an interdisciplinary primary care model

Journal of the American Board of Family Medicine Sep 14, 2019

Cantone RE, Garvey B, O'Neill A, et al. - Given the underuse of medication-assisted treatment (MAT) for opioid use disorder (OUD) in primary care, as well as the little available knowledge on patient demographics related to MAT start—especially among models with an interdisciplinary approach, including behavioral health integration— researchers investigated whether implementing this model for OUD would result in few differences in MAT initiation by patient features. Participants included adults with ≥ 1 primary care visit in one of two study clinics in a Pacific Northwest academic health system. Higher odds of initiating MAT were observed in patients with documented psychiatric diagnoses or tobacco. Lower odds were reported in uninsured, Medicaid, and Medicare patients vs those commercially insured. Lower odds of initiation were also observed in those who were older, of a race/ethnicity other than non-Hispanic white, had documented diabetes, and had documented asthma or chronic obstructive pulmonary disease. The differences in care were not eliminated after the addition of behavioral health, but the reach of this model to some vulnerable populations was indicated by the observed higher odds of initiation among those with documented psychiatric diagnoses.

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