Browsing by Subject "Opioid addiction"

Now showing 1 - 3 of 3
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    Exploring the Demographic and Professional Characteristics of Physicians and Nurse Practitioners Associated With Providing Medication-Assisted Treatment: A Retrospective Observational Study
    (Sage, 2024) Maxey, Hannah L.; Vaughn, Sierra X.; Dickinson, Analise; Newhouse, Robin; Medicine, School of Medicine
    Integration of medication-assisted treatment (MAT) for opioid use disorder in primary care settings is an emerging health care delivery model that supports increased access to specialized care but requires primary care provider engagement. Examining the characteristics of providers who provide this service is key to informing targeted recruitment. Using administrative and supplemental data collected during license renewal, this study aimed to identify the characteristics of primary care physicians and nurse practitioners (NPs) associated with greater odds of providing MAT in their practice. A retrospective observational study was conducted using a descriptive correlational design. The analysis included 5259 physicians and 3486 NPs who renewed their licenses electronically in 2021 and specialized in primary care or psychiatry. Chi-square and logistic regression analyses were conducted to identify the demographic and clinical characteristics of physicians and NPs associated with MAT participation in their practice. Physicians had a higher odds ratio (OR) of providing MAT if they were younger than 35 years (OR = 1.334; P = .0443), practiced in a federally qualified health center (OR = 3.101, P < .0001), and offered a sliding fee scale in their practice (OR = 2.046; P < .0001). Likewise, NPs had higher odds of providing MAT if they practiced in a public or community health center (OR = 3.866; P < .0001). The results of this study highlight the personal and professional characteristics of physicians and NPs associated with higher odds of providing MAT. These findings may have implications for the recruitment and sustainability of MAT integration in primary care.
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    Identify Opiod Use Problem
    (2018-12) Alzeer, Abdullah Hamad; Jones, Josette; Dixon, Brian; Bair, Matthew; Liu, Xiaowen
    The aim of this research is to design a new method to identify the opioid use problems (OUP) among long-term opioid therapy patients in Indiana University Health using text mining and machine learning approaches. First, a systematic review was conducted to investigate the current variables, methods, and opioid problem definitions used in the literature. We identified 75 distinct variables in 9 models that majorly used ICD codes to identify the opioid problem (OUP). The review concluded that using ICD codes alone may not be enough to determine the real size of the opioid problem and more effort is needed to adopt other methods to understand the issue. Next, we developed a text mining approach to identify OUP and compared the results with the current conventional method of identifying OUP using ICD-9 codes. Following the institutional review board and an approval from the Regenstrief Institute, structured and unstructured data of 14,298 IUH patients were collected from the Indiana Network for Patient Care. Our text mining approach identified 127 opioid cases compared to 45 cases identified by ICD codes. We concluded that the text mining approach may be used successfully to identify OUP from patients clinical notes. Moreover, we developed a machine learning approach to identify OUP by analyzing patients’ clinical notes. Our model was able to classify positive OUP from clinical notes with a sensitivity of 88% on unseen data. We concluded that the machine learning approach may be used successfully to identify the opioid use problem from patients’ clinical notes.
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    The intervening role of urgency on the association between childhood maltreatment, PTSD, and substance-related problems
    (Elsevier, 2017-06) Mirhashem, Rebecca; Allen, Holley C.; Adams, Zachary W.; van Stolk-Cooke, Katherine; Legrand, Alison; Price, Matthew; Psychiatry, School of Medicine
    A range of risk factors lead to opioid use and substance-related problems (SRP) including childhood maltreatment, elevated impulsivity, and psychopathology. These constructs are highly interrelated such that childhood maltreatment is associated with elevated impulsivity and trauma-related psychopathology such as posttraumatic stress disorder (PTSD), and impulsivity-particularly urgency-and PTSD are related. Prior work has examined the association between these constructs and substance-related problems independently and it is unclear how these multi-faceted constructs (i.e., maltreatment types and positive and negative urgency) are associated with one another and SRP. The current study used structural equation modeling (SEM) to examine the relations among childhood maltreatment, trait urgency, PTSD symptoms, and SRP in a sample of individuals with a history of opioid use. An initial model that included paths from each type of childhood maltreatment, positive and negative urgency, PTSD and SRP did not fit the data well. A pruned model with excellent fit was identified that suggested emotional abuse, positive urgency, and negative urgency were directly related to PTSD symptoms and only PTSD symptoms were directly related to SRP. Furthermore, significant indirect effects suggested that emotional abuse and negative urgency were related to SRP via PTSD symptom severity. These results suggest that PTSD plays an important role in the severity of SRP.