PROTOCOL NIDA-CTN-0066-Ot


Opioid Use Disorders in Primary Care Settings: Linking EHRs with PDMP and National Death Index Data Systems

Principal Investigator
Yih-Ing Hser, PhD
Integrated Substance Abuse Programs, UCLA
ysher@ucla.edu

Opioid addiction is associated with excess mortality, morbidities, and other adverse health and social conditions. Most knowledge of opioid addiction, however, is based on studies of individuals treated in publicly-funded specialty programs. At present there is limited information about patterns of opioid use, related infectious disease (HIV, hepatitis C), and other co-morbidity, and health care utilization among individuals treated in primary care settings. The availability of electronic health records (EHRs) provides the opportunity to examine the health status and service use among large and diverse primary care samples. This study will analyze electronic health records of individuals treated for opioid addiction in a primary care network and will link EHR data with two other existing data systems (i.e., Prescription Drug Monitoring Program or PDMP, National Death Index) in order to generate actionable knowledge and identify ways to improve care.

PRIMARY FINDINGS

Mortality data were linked with electronic health records of 2,576 OUD patients cared for in a large university health system from 2006-2014. There were 465 deaths confirmed (18.1% of the study participants), corresponding to a crude mortality rate of 48.6 per 1000 person-years and standardized mortality ratio of 10.3 (95% confidence level [CI] 9.4-11.3). Drug overdose and disorder (19.8%), cardiovascular diseases (17.4%), cancer (16.8%), and infectious disseases (13.5%, including 12% hepatitis C virus (HCV)) were the leading causes of death. HCV (hazard ratio [HR] 1.99, 95% CI 1.62-2.46) and alcohol use disorder (HR 1.27, 95% CI 1.05-1.55) were two clinically important indicators of overall mortality risk.

Results Article: Hser Y, Mooney LJ, Saxon AJ, et al. High Mortality Among Patients with Opioid Use Disorder in a Large Healthcare System. Journal of Addiction Medicine 2017;11(4):315-319. [get article]

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