Research News Roundup: January 16, 2025

Journal: Annals of Medicine, 2025, doi: 10.1080/07853890.2024.2447413

Authors: Oliver Ethan Goal, Isca Amanda, Cameron Adams, & Maria Adela Grando

Abstract:

Introduction: There is a need to assess the delivery of interventions to improve substance use disorder (SUD) treatment, as measured by the Healthcare Effectiveness Data and Information Set (HEDIS®) metrics. The goal was to characterize published articles reporting HEDIS® SUD measures and recommend future work on applying and investigating SUD HEDIS® metrics and their effect on SUD treatments.

Materials and Methods: The PRISMA-ScR scoping review protocol was used to find published work and investigate the most common reported baseline characteristics, HEDIS® metric outcomes, and knowledge gaps. Peer-reviewed papers available through PubMed, Academic Search Premier, Elsevier/ScienceDirect, and Medline were searched up to August 14, 2022.

Results: Twenty-eight articles were included after removing 92 duplications. Twenty-five articles were retrospective cohort studies, two were RCTs, and there was a mixed-method study. SUD metrics were studied in diverse settings, including ED, primary care, mental health care, and SUD specialty care. Twenty-seven papers utilized the Initiation and Engagement of Substance Use Disorder Treatment (IET) measure, and 13 had similar data sources, study populations, and authors. Eight papers presented IET results by substance used, primarily alcohol, cannabis, and opioids.

Conclusions: More research is needed on the HEDIS® SUD metrics and their usefulness in informing SUD prevention and treatment, policy, and public health outcomes.

To read the full text of the article, please visit the publisher’s website.

Journal: Addictive Behaviors Reports, 2025, doi: 10.1016/j.abrep.2025. 100584

Authors: Sylvia A. Okon, Tourna N. Khan, Nora J. Duffy, Carson C. Roan, & Rachel A. Hoopsick

Abstract:

Work-related stress has been well-examined among physicians, but little is known about how it might affect drug use or healthcare workers in lower-wage occupations characterized by high job demands and low occupational autonomy (e.g., medical assistants, nursing assistants). We collected data from a diverse sample of healthcare workers (N = 200) and separately examined the cross-sectional relationships between several work-related experiences (i.e., compassion satisfaction, burnout, and secondary traumatic stress) and measures of current drug use (i.e., non-medical use of prescription drugs [NMUPD], cannabis use, and illicit drug use). We then examined for differences in these relationships by occupational level (i.e., prescriber/administrator vs. other healthcare worker). In main effects models, greater burnout and secondary traumatic stress were both associated with higher odds of NMUPD, cannabis use, and illicit drug use (ps < 0.01). Greater compassion satisfaction was associated with lower odds of illicit drug use (p < 0.05), but not with NMUPD or cannabis use (ps > 0.05). There was a significant interaction between secondary traumatic stress and occupational level on NMUPD (p < 0.05) such that there was no relationship among prescribers/administrators, but the likelihood of NMUPD increased with greater secondary traumatic stress among other healthcare workers. Similar trend-level interactions were observed between secondary traumatic stress and occupational level on cannabis use (p < 0.10) and between burnout and occupational level on NMUPD. Burnout and secondary traumatic stress may contribute to drug use, and lower-wage healthcare workers may be especially vulnerable.

To read the full text of the article, please visit the publisher’s website.

Journal: JAMA Network Open, 2025, doi:10.1001/jamanetworkopen. 2024.53303

Authors: Auty, S. G., Frakt, A. B., Shafer, P. R., Stein, M. D., & Gordon S. H.

Abstract:

Importance: Pregnant people with opioid use disorder (OUD) are at high risk for potentially avoidable maternal morbidity. The majority of pregnant people with OUD receive health insurance through state Medicaid programs, but there is little comprehensive data on the burden of severe maternal morbidity (SMM)—a composite measure of adverse maternal health outcomes—among this high-risk group.

Objective: To estimate rates of SMM among Medicaid-enrolled pregnant people with OUD from 2016 to 2018.

Design, Setting, and Participants: Using the Transformed Medicaid Statistical Information System Analytic Files, this cross-sectional study identified 96 309 pregnant people with OUD enrolled in Medicaid in 47 states with 108 975 deliveries between March 1, 2016, and November 16, 2018. Data were analyzed from August 1, 2023, to September 1, 2024.

Main Outcome and Measures: SMM was identified using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis and procedure codes for 20 relevant conditions and was measured per 10 000 live births nationally and by state. Rates of SMM were also stratified by the timing of Medicaid enrollment before delivery.

Results: From 2016 to 2018, 96 309 Medicaid enrollees had a diagnosis of OUD before a live birth (108 975 deliveries). The mean (SD) age of Medicaid-enrolled pregnant people with OUD was 28.8 (5.0) years. The mean (SD) rate of OUD among pregnant people enrolled in Medicaid was 324.8 (260.9) per 10 000 live births across states. Among this group, the mean (SD) unadjusted rate of SMM excluding blood transfusions among those with OUD was 292.1 (112.3) per 10 000 live births, with these rates varying substantially across states, from 101.0 per 10 000 live births in South Dakota to 682.2 per 10 000 live births in California. Adjustment for enrollee characteristics and comorbidities did not meaningfully alter the estimated rate of SMM (305.6 [95% CI, 245.2-408.2] per 10 000 live births). Rates of SMM generally increased with decreased durations of Medicaid enrollment.

Conclusions and Relevance: This cross-sectional study of pregnant people enrolled in Medicaid found that the rate of OUD among this group was more than twice as high as previous estimates. Pregnant people with OUD face a disproportionately high risk of SMM, particularly those who enroll in Medicaid later in pregnancy. Targeted interventions that facilitate early Medicaid enrollment and coverage continuity may be needed to reduce the burden of adverse outcomes in this group.

To read the full text of the article, please visit the publisher’s website.

Journal: BMJ Open, 2025, doi: 10.1136/bmjopen-2024-090462

Authors: Anthony W. Olson, Andrei Bucaloiu, Clayton I. Allen, Lorraine D. Tusing, Hillary A. Henzler-Buckingham, Christina M. Gregor, … Katrina M. Romagnoli

Abstract:

Objectives: This substudy’s objectives were to (1) examine the transferability of a four archetype framework (simplified pattern of prototypical features) for patients at high risk for opioid use disorder (OUD) developed from a previous study with a similar population; (2) explore how patient preferences for terminology can inform clinician communication strategies for patients with OUD across archetypes and (3) explore how patient perceptions of opioid risks can inform clinician communication strategies across patient archetypes.

Design: This qualitative study collected data via semistructured phone interviews with patients about views on opioid-related discussions with primary care clinicians. Qualitative data were coded using the Rigorous and Accelerated Data Reduction technique and analysed via iterative inductive/deductive thematic analysis.

Setting: 40 primary care clinics affiliated with two health systems (site1=Pennsylvania; site2=Minnesota, Wisconsin and North Dakota).

Participants: 40 adults meeting one of the following: OUD diagnosis; taking medication for OUD (MOUD) and ≥3 opioid prescriptions in the previous year.

Results: The aforementioned four archetype framework transferred well to the study sample and hinted at archetype differences in participant OUD-terminology preferences and opioid risk perceptions. Two additional archetypes of ‘in treatment/recovery for OUD and not taking MOUD’ and ‘in treatment/recovery for OUD and taking MOUD’ were identified. Participants best fitting archetypes 1–4 preferred clinicians to refrain from using addiction terminology to describe their relationship with opioids, finding the term ‘dependence’ as more appropriate and a signal that clinicians cared for patients. Participants who best first archetypes 5–6 felt ‘addiction’ was an appropriate, direct term that accurately described their condition, often using it themselves. Patients in all archetypes recognised risks of harm from using opioids, especially participants fitting archetypes 2, 5 and 6 who conveyed the greatest concern.

Conclusion: The modified six archetype framework may help clinicians tailor their communication and care for patients diagnosed with or at high risk for OUD.

Trial registration number NCT04198428.

To read the full text of the article, please visit the publisher’s website.