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Medications for Alcohol Use Disorder: Rates and Predictors of Prescription Order and Fill in Outpatient Settings.
Hodgkin, Dominic; Busch, Alisa B; Kennedy-Hendricks, Alene; Azeni, Hocine; Horgan, Constance M; Uscher-Pines, Lori; Huskamp, Haiden A.
Afiliación
  • Hodgkin D; Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA. hodgkin@brandeis.edu.
  • Busch AB; Harvard Medical School, Harvard University, Boston, MA, USA.
  • Kennedy-Hendricks A; McLean Hospital, Belmont, MA, USA.
  • Azeni H; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
  • Horgan CM; Harvard Medical School, Harvard University, Boston, MA, USA.
  • Uscher-Pines L; Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.
  • Huskamp HA; RAND Corporation, Arlington, VA, USA.
J Gen Intern Med ; 39(14): 2708-2715, 2024 Nov.
Article en En | MEDLINE | ID: mdl-39187721
ABSTRACT

BACKGROUND:

Alcohol use disorders (AUD) are prevalent and responsible for substantial morbidity and mortality; yet efficacious treatments are underused. Previous studies have identified demographic and clinical predictors of medication fills, yet these studies typically do not include patients who were prescribed a medication but did not fill it.

OBJECTIVES:

To examine rates of and factors associated with prescription order and prescription fill for medications for AUD (MAUD) among individuals diagnosed with AUD in outpatient settings.

DESIGN:

In a cross-sectional analysis, we used multivariate logistic regression to identify factors associated with prescription order and fill. PATIENTS We used data from the Optum Labs Data Warehouse that linked 2016-2021 de-identified claims and electronic health record (EHR) data, allowing us to observe prescription orders and whether they were filled. We identified 14,674 patients aged ≥ 18 who had an index outpatient encounter with an AUD diagnosis in the EHR. KEY

MEASURES:

We computed the proportion for whom a MAUD prescription was ordered within 1 year of index visit, and for whom one was filled within 30 days of the order. KEY

RESULTS:

5.8% of the sample had a MAUD prescription order within 1 year of their index visit. Among those with an order, 87% filled their MAUD prescription within 30 days of receipt (i.e., 5.1% of full sample). After multivariable adjustment, receipt of a MAUD prescription order was more likely for patients who were female (adjusted odds ratio (aOR) [95%CI] = 1.44 [1.24-1.67]), or had moderate or severe AUD (1.74 [1.50-2.01]). Patients receiving an order were more likely to fill it if they had a comorbid mental disorder (1.64 [1.09-2.49]).

CONCLUSIONS:

The low rate of prescription orders was notable. Low use of MAUD appears to result chiefly from prescription order decisions, rather than from prescription fill decisions made by patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alcoholismo Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Gen Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Alcoholismo Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Gen Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos