Cohort profile: the provincial opioid agonist treatment cohort in Ontario, Canada

IF 7.7 1区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

European Journal of Epidemiology Pub Date : 2025-01-27 DOI:10.1007/s10654-025-01202-3

Kristen A. Morin, Mark R. Tatangelo, Shreedhar Acharya, David C. Marsh

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引用次数: 0

Abstract

Background

Opioid Agonist Treatment (OAT) is the most effective intervention for opioid use disorder (OUD), but retention has decreased due to increasingly potent drugs like fentanyl. This cohort can be used retrospectively to observe trends in service utilization, healthcare integration, healthcare costs and patient outcomes. It also facilitates the design of observational studies to mimic a prospective design.

Methods

This study used linked administrative data from ICES to create a cohort of 137,035 individuals who received at least one prescription of methadone or buprenorphine/naloxone between 2014 and 2022. Data were linked using de-identified personal health numbers. Variables included age, sex, rurality, income, homelessness, and mental health conditions. Regional differences in OAT use, retention, and mortality were analyzed.

Results

Of the cohort, 56.1% began OAT after 2014. Southern Ontario participants more often started on methadone (53.2%), while Northern Ontario patients favored buprenorphine/naloxone (62.7%). Northern patients were younger, more likely to be female, live in rural areas, and face homelessness. The death rate was higher in Southern Ontario (22.1%) than in Northern Ontario (13.2%). Retention declined over time, with 73.4% of patients remaining in treatment at the study's end.

Conclusions

The findings highlight regional disparities in OAT delivery and emphasize the need for region-specific strategies, particularly in rural areas, to improve retention and reduce mortality.

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来源期刊

European Journal of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

21.40

自引率

1.50%

发文量

109

审稿时长

6-12 weeks

期刊介绍： The European Journal of Epidemiology, established in 1985, is a peer-reviewed publication that provides a platform for discussions on epidemiology in its broadest sense. It covers various aspects of epidemiologic research and statistical methods. The journal facilitates communication between researchers, educators, and practitioners in epidemiology, including those in clinical and community medicine. Contributions from diverse fields such as public health, preventive medicine, clinical medicine, health economics, and computational biology and data science, in relation to health and disease, are encouraged. While accepting submissions from all over the world, the journal particularly emphasizes European topics relevant to epidemiology. The published articles consist of empirical research findings, developments in methodology, and opinion pieces.