Few patients receive follow-up after opioid overdose
Just 16.6% of commercially insured patients receive follow-up care after being released from the ED for a nonfatal opioid overdose, according to a study published in JAMA Network Open.
“The ED encounter has been seen as a critical opportunity to engage a patient and connect them to the right care that gives them the best chance for recovery,” Austin S. Kilaru, MD, an ED physician and a fellow in the National Clinician Scholars Program at the University of Pennsylvania, said in a press release. “However, even with commercially insured patients, who likely have superior ability to access care, we see these low treatment rates, particularly for minorities. There's more work to be done, and these findings give us a comprehensive picture of the gaps and disparities that could help inform those efforts moving forward.”
Kilaru and colleagues used insurance claims data from a large commercial insurer in the United States from October 2011 through September 2016 to assess follow-up treatment 90 days after an ED visit for an opioid overdose.
A total of 6,451 patients with a mean age of 45 years were included in the study. Of those, researchers found that 16.6% (95% CI, 15.7-17.5) received follow-up treatment within 90 days of an opioid overdose.
Among patients who had not previously received treatment for opioid use disorder during the 90 days before their overdose, Kilaru and colleagues found that 11.1% (95% CI, 10.3-12) received follow-up treatment after their overdose.
In comparison, they found that 62.5% (95% CI, 58.7-66.1) of those who had previously undergone treatment for opioid use disorder received follow-up treatment after experiencing an opioid overdose.
The researchers determined that among patients who had not been given treatment before their overdose, black patients were half as likely to receive follow-up care compared with white patients (absolute risk difference [ARD] = 5.9%; 95% CI, 8.6 to 3.6).
In addition, Kilaru and colleagues found that women (ARD = 1.7%; 95%CI, 3.3 to 0.5) and Hispanic patients (ARD = 3.5%; 95% CI,6.1 to0.9) were less likely to receive follow-up care after an opioid overdose.
They also determined that with each year of age, patients were 0.2% (95% CI, 0.3 to 0.1) less likely to receive follow-up treatment.
In an editorial accompanying the study, Elizabeth M. Schoenfeld, MD, MS, assistant professor of emergency medicine at the University of Massachusetts Medical School – Baystate, and colleagues wrote that the findings suggest there are significant barriers for opioid use disorder treatment, and that “at the height of the opioid epidemic, we as a health care community are missing opportunities to save lives.”
“Increasing knowledge, reducing stigma, addressing logistics, decreasing regulations, and providing incentives to treat patients with [opioid use disorder] must all be considered if we are to truly make a difference,” they wrote. – by Erin Michael
Disclosures: Kilaru reports no relevant financial disclosures. Schoenfeld reports receiving a grant from the Agency for Health Research and Quality. Please see the study for all other authors’ relevant financial disclosures.