Receipt of medications for opioid use disorder among rural and urban veterans health administration patients
Aim: We examined differences in medications for opioid use disorder (MOUD) receipt between rural and urban veteran patients following initiatives within the US Department of Veterans Affairs (VA) to expand access to MOUD. Methods: Data for this retrospective cohort study were obtained from the VA Co...
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| Language: | English |
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Elsevier
2025-03-01
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| Series: | Drug and Alcohol Dependence Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772724624000957 |
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| author | Olivia C. Reynolds Kathleen F. Carlson Adam J. Gordon Robert L. Handley Benjamin J. Morasco Todd P. Korthuis Travis I. Lovejoy Jessica J. Wyse |
| author_facet | Olivia C. Reynolds Kathleen F. Carlson Adam J. Gordon Robert L. Handley Benjamin J. Morasco Todd P. Korthuis Travis I. Lovejoy Jessica J. Wyse |
| author_sort | Olivia C. Reynolds |
| collection | DOAJ |
| description | Aim: We examined differences in medications for opioid use disorder (MOUD) receipt between rural and urban veteran patients following initiatives within the US Department of Veterans Affairs (VA) to expand access to MOUD. Methods: Data for this retrospective cohort study were obtained from the VA Corporate Data Warehouse, which contains national electronic health record data for all VA patients. The analytic sample included all patients diagnosed with OUD from 10/1/2018–9/30/20. Rurality was identified by the Rural Urban Commuting Area (RUCA) code of patients’ home address. Associations between rurality and MOUD receipt, as well as type of MOUD received, were examined using logistic regression. Results: Among 66,842 patients with OUD, 27.4 % were rural residents. Compared to urban patients, rural patients were slightly younger (50.1 vs. 52.5 years), more often white (87.7 % vs. 70.3 %) and less often received MOUD (42.6 % vs 45.5 %). Multivariable models confirmed that rural patients had a lower likelihood of accessing any form of MOUD (aOR= 0.84, 95 % CI: 0.81–0.87) relative to urban VA patients. Medication-specific analyses identified a lower likelihood of receiving methadone (aOR= 0.36, 95 % CI: 0.33–0.39) and naltrexone (aOR= 0.89, 95 % CI: 0.80–0.99) among rural patients, but higher likelihood of receiving buprenorphine (aOR= 1.05, 95 % CI: 1.01–1.09). Conclusion: Rural VA patients have a lower likelihood of receiving methadone and naltrexone for OUD treatment relative to urban patients, but greater likelihood of receiving buprenorphine. Continued work is needed to ensure that rural Veterans have equitable access to the most appropriate medication for their health care needs. |
| format | Article |
| id | doaj-art-10a6ae0719ce4fd8954925dfdece4fe0 |
| institution | DOAJ |
| issn | 2772-7246 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Drug and Alcohol Dependence Reports |
| spelling | doaj-art-10a6ae0719ce4fd8954925dfdece4fe02025-08-20T02:44:03ZengElsevierDrug and Alcohol Dependence Reports2772-72462025-03-011410031110.1016/j.dadr.2024.100311Receipt of medications for opioid use disorder among rural and urban veterans health administration patientsOlivia C. Reynolds0Kathleen F. Carlson1Adam J. Gordon2Robert L. Handley3Benjamin J. Morasco4Todd P. Korthuis5Travis I. Lovejoy6Jessica J. Wyse7Center to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, United States; School of Public Health, Oregon Health & Science University, 840 SW Gaines St, Portland, OR 97239, United States; Correspondence to: 3710 SW US Veterans Hospital Road, Portland, OR 97239, United States.Center to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, United States; School of Public Health, Oregon Health & Science University, 840 SW Gaines St, Portland, OR 97239, United StatesInformatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT 84148, United States; Division of Epidemiology & Department of Internal Medicine, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT 84132, United StatesCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, United StatesCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, United States; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, United StatesSchool of Public Health, Oregon Health & Science University, 840 SW Gaines St, Portland, OR 97239, United States; Department of Medicine, Division of General Internal Medicine & Geriatrics, Section of Addiction Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United StatesCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, United States; Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, United States; VA Office of Rural Health, Veterans Rural Health Resource Center-Portland, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, United StatesCenter to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, United States; School of Public Health, Oregon Health & Science University, 840 SW Gaines St, Portland, OR 97239, United StatesAim: We examined differences in medications for opioid use disorder (MOUD) receipt between rural and urban veteran patients following initiatives within the US Department of Veterans Affairs (VA) to expand access to MOUD. Methods: Data for this retrospective cohort study were obtained from the VA Corporate Data Warehouse, which contains national electronic health record data for all VA patients. The analytic sample included all patients diagnosed with OUD from 10/1/2018–9/30/20. Rurality was identified by the Rural Urban Commuting Area (RUCA) code of patients’ home address. Associations between rurality and MOUD receipt, as well as type of MOUD received, were examined using logistic regression. Results: Among 66,842 patients with OUD, 27.4 % were rural residents. Compared to urban patients, rural patients were slightly younger (50.1 vs. 52.5 years), more often white (87.7 % vs. 70.3 %) and less often received MOUD (42.6 % vs 45.5 %). Multivariable models confirmed that rural patients had a lower likelihood of accessing any form of MOUD (aOR= 0.84, 95 % CI: 0.81–0.87) relative to urban VA patients. Medication-specific analyses identified a lower likelihood of receiving methadone (aOR= 0.36, 95 % CI: 0.33–0.39) and naltrexone (aOR= 0.89, 95 % CI: 0.80–0.99) among rural patients, but higher likelihood of receiving buprenorphine (aOR= 1.05, 95 % CI: 1.01–1.09). Conclusion: Rural VA patients have a lower likelihood of receiving methadone and naltrexone for OUD treatment relative to urban patients, but greater likelihood of receiving buprenorphine. Continued work is needed to ensure that rural Veterans have equitable access to the most appropriate medication for their health care needs.http://www.sciencedirect.com/science/article/pii/S2772724624000957RuralVeteransAccessOpioid agonistOpioid use disorder |
| spellingShingle | Olivia C. Reynolds Kathleen F. Carlson Adam J. Gordon Robert L. Handley Benjamin J. Morasco Todd P. Korthuis Travis I. Lovejoy Jessica J. Wyse Receipt of medications for opioid use disorder among rural and urban veterans health administration patients Drug and Alcohol Dependence Reports Rural Veterans Access Opioid agonist Opioid use disorder |
| title | Receipt of medications for opioid use disorder among rural and urban veterans health administration patients |
| title_full | Receipt of medications for opioid use disorder among rural and urban veterans health administration patients |
| title_fullStr | Receipt of medications for opioid use disorder among rural and urban veterans health administration patients |
| title_full_unstemmed | Receipt of medications for opioid use disorder among rural and urban veterans health administration patients |
| title_short | Receipt of medications for opioid use disorder among rural and urban veterans health administration patients |
| title_sort | receipt of medications for opioid use disorder among rural and urban veterans health administration patients |
| topic | Rural Veterans Access Opioid agonist Opioid use disorder |
| url | http://www.sciencedirect.com/science/article/pii/S2772724624000957 |
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