Preventive and Chronic Illness Care Poorer Among Individuals With Opioid Use Disorder

Individuals with opioid use disorder (OUD) received moderately lower quality of non-OUD care than individuals without OUD. These finding were published in JAMA Network Open.

Researchers from the Johns Hopkins Bloomberg School of Public Health used data from the OptumLabs Data Warehouse for this cross-sectional study. Individuals with OUD (n=79,372) and matched individuals without OUD (n=79,372) were assessed for quality of preventative care (breast cancer screening), chronic illness care (statin adherence, diabetes control), and coordination of care (mental health follow-up, avoidable hospitalizations).

The study population comprised 55.1% women who were 62.1% White, aged mean 59.0 (standard deviation [SD], 16.1) years. All sociodemographic and comorbidity characteristics differed by <0.1 SD.

For preventative care, among the women who were eligible for mammography screening, 55.4% (95% CI, 54.7%-56.0%) of those with OUD and 65.6% (95% CI, 64.4%-66.7%) without OUD underwent a breast cancer screening (P <.001).

For care of chronic illness, among those with coronary artery disease, fewer individuals with OUD received quality of care for adherence to statin therapy (70.4%; 95% CI, 68.7%-72.1%) compared with controls (76.7%; 95% CI, 74.4%-78.7%; P <.001). Similarly, among those with diabetes, fewer with OUD received glycated hemoglobin testing (80.9%; 95% CI, 80.4%-81.5%) than the matched controls (85.8%; 95% CI, 84.9%-86.8%; P <.001).

After an emergency visit for a mental health condition, 45.3% (95% CI, 44.6%-46.0%) of the OUD cohort and 52.5% (95% CI, 50.0%-55.0%) of those without OUD received a mental health follow-up at 30 days. More individuals with OUD had a potentially avoidable hospitalization for a chronic condition (11.4%; 95% CI, 11.2%-11.7%) than the non-OUD cohort (8.8%; 95% CI, 8.3%-9.2%; P <.001).

This study was possibly limited by selecting quality of care measurements which were easy to assess.

These data indicated individuals who had OUD received poorer quality of care for chronic conditions or preventative medicine than matched individuals who did not have OUD. Models for improving quality of care for these individuals is needed.

Disclosure: Multiple authors declared industry affiliations. Please refer to the original article for a full list of disclosures.

Reference

Anderson KE, Alexander C, Niles L, Scholle SH, Saloner B, Dy SM. Quality of preventive and chronic illness care for insured adults with opioid use disorder. JAMA Netw Open. 2021;4(4):e214925. doi:10.1001/jamanetworkopen.2021.4925