Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Sep 6, 2022
Date Accepted: Jul 24, 2023
Trends in Opioid Medication Adherence During the COVID-19 Pandemic: Retrospective Cohort Study
ABSTRACT
Background:
The recent pandemic has had the potential to worsen the opioid crisis through multiple effects on patients’ lives, such as disruption of care. In particular, good levels of adherence with respect to Medication for Opioid Use Disorder (MOUD), recognised as important for positive outcomes, may be disrupted.
Objective:
To investigate whether patients on opioid MOUD experienced a drop in adherence to their medication during the recent COVID-19 pandemic.
Methods:
This retrospective cohort study uses the Medicaid claims data from six US states from 2018 until the start of 2021 to compare medication adherence for people on MOUD before and after the beginning of the COVID-19 pandemic in March 2020. Our main measure is the Proportion of Days Covered (PDC), a score to measure patients’ adherence to their MOUD medication. We carry out a breakpoint analysis on PDC, followed by a patient-level beta regression analysis with PDC as dependent variable, controlling for a set of covariates.
Results:
A total of 79,991 PDC scores were calculated for 37,604 patients (age: mean [SD] 37.6 [9.8] years; sex: 17,825 (47.4%) women) between 2018 and 2021. The coefficient for the effect of COVID-19 on PDC score is -0.076 and statistically significant (OR = 0.925; 95%CI = 0.90, 0.94).
Conclusions:
The COVID-19 pandemic is negatively associated with patients’ adherence to their medication, which has declined since the beginning of the pandemic.
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