The effect of person, treatment and prescriber characteristics on retention in opioid agonist treatment: a 15-year retrospective cohort study

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dc.contributor.authorBharat, C.
dc.contributor.authorLarney, S.
dc.contributor.authorBarbieri, S.
dc.contributor.authorDobbins, T.
dc.contributor.authorJones, N.R.
dc.contributor.authorHickman, M.
dc.contributor.authorGisev, N.
dc.contributor.authorAli, R.
dc.contributor.authorDegenhardt, L.
dc.date.issued2021
dc.descriptionFirst published: 12 May 2021
dc.description.abstractBackground and Aims: There is limited evidence on the relationship between retention in opioid agonist treatment for opioid dependence and characteristics of treatment prescribers. This study estimated retention in buprenorphine and methadone treatment and its relationship with person, treatment and prescriber characteristics. Design Retrospective longitudinal study. Setting New South Wales, Australia. Participants: People entering the opioid agonist treatment programme for the first time between August 2001 and December 2015. Measurements: Time in opioid agonist treatment (primary outcome) was modelled using a generalized estimating equation model to estimate associations with person, treatment and prescriber characteristics. Findings: The impact of medication type on opioid agonist treatment retention reduced over time; the risk of leaving treatment when on buprenorphine compared with methadone was higher among those who entered treatment earlier [e.g. 2001–03: odds ratio (OR) = 1.59, 95% confidence interval (CI) = 1.45–1.75] and lowest among those who entered most recently (2013–15: OR = 1.23, 95% CI = 1.11–1.36). In adjusted analyses, risk of leaving was reduced among people whose prescriber had longer tenure of prescribing (e.g. 3 versus 8 years: OR = 0.94, 95% CI = 0.93–0.95) compared with prescribers with shorter tenure. Aboriginal and Torres Strait Islander people, being of younger age, past-year psychosis disorder and having been convicted of more criminal charges in the year prior to treatment entry were associated with increased risk of leaving treatment. Conclusion: In New South Wales, Australia, retention in buprenorphine treatment for opioid dependence, compared with methadone, has improved over time since its introduction in 2001. Opioid agonist treatment retention is affected not only by characteristics of the person and his or her treatment, but also of the prescriber, with those of longer prescribing tenure associated with increased retention of people in opioid agonist treatment.
dc.description.statementofresponsibilityChrianna Bharat, Sarah Larney, Sebastiano Barbieri, Timothy Dobbins, Nicola R. Jones, Matthew Hickman ... et al.
dc.identifier.citationAddiction, 2021; 116(11):3139-3152
dc.identifier.doi10.1111/add.15514
dc.identifier.issn0965-2140
dc.identifier.issn1360-0443
dc.identifier.orcidAli, R. [0000-0003-2905-8153]
dc.identifier.urihttp://hdl.handle.net/2440/130904
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1135991
dc.rights© 2021 Society for the Study of Addiction.
dc.source.urihttps://doi.org/10.1111/add.15514
dc.subjectBuprenorphine
dc.subjectmethadone
dc.subjectopiate substitution treatment
dc.subjectopioid agonist treatment
dc.subjectopioid dependence
dc.subjectretention
dc.titleThe effect of person, treatment and prescriber characteristics on retention in opioid agonist treatment: a 15-year retrospective cohort study
dc.typeJournal article
pubs.publication-statusPublished

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