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Beaumont, Scott

University of British Columbia

Background: Across different types of oral Opioid Agonist Treatment for people with Opioid Use Disorder, receiving a dose that meets clients’ needs is associated with better outcomes. Evidence also shows clients are more likely to receive an “adequate dose” when their prescribers involve them in decision making. Neither of these findings have been studied in the context of injectable Opioid Agonist Treatment, which is the purpose of this study. Methods: This study was a retrospective analysis of an 18-month prospective longitudinal cohort of 131 injectable Opioid Agonist Treatment clients. Participant-observations were collected at the start, and then at months 2, 4, 6, 8, 10, 12, and 18. Starting at month 6, participants were asked whether their dose was satisfactory to them (outcome variable). To account for multiple observations from each participant, Generalized Estimating Equations were used. Bivariate and multivariate analyses were conducted with variables of interest. Building of the final model used a stepwise approach. Results: 545 participant-observations were included in the analysis. These were grouped by “dose is satisfactory” and “wants higher dose”. From unadjusted analyses, participants were less likely to report being satisfied with their dose if they: were Indigenous, had worse psychological or physical health problems, had ever attempted suicide, were younger when they first injected any drug, were a current smoker, felt troubled by drug problems, gave their medication a lower “drug liking” score, and felt that their doctor was not including them in decisions the way they wanted to be. In the final multivariate model, all previously significant associations except for “current smoker” and “troubled by drug problems” were no longer significant after the addition of the “drug liking” score. Conclusions: These findings suggest that improving shared decision-making in iOAT may enhance dose satisfaction, which is associated with reduced substance use–related concerns and greater acceptance of prescribed medications. The association between dose dissatisfaction and disliking the medication highlights the clinical importance of increasing available medication and formulation options. Policies that support patient-centered approaches and broaden access to different opioid agonists may be critical to achieving more effective care for individuals with opioid use disorder.

Text

2025-04-30

Attribution-NonCommercial-ShareAlike 4.0 International

http://hdl.handle.net/2429/90908

Population and Public Health

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-sa/4.0/