Diagnosis and treatment of opioid use disorder in a South African private sector medical insurance scheme: a cohort study: Opioids

2022 MAY 18 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- According to news reporting based on a preprint abstract, our journalists obtained the following quote sourced from medrxiv.org:

“Background: The use of opioids is increasing globally, but data on opioid use disorder (OUD) in South Africa are scarce.

“This study examines the incidence of diagnosed OUD, opioid agonist use, and excess mortality among persons with OUD in South Africa9s private healthcare sector. Methods: We conducted a cohort study of beneficiaries (11 years or older) of a South African medical insurance scheme using reimbursement claims from Jan 1, 2011, to Jul 1, 2020. Beneficiaries were classified as having OUD if they received opioid agonists (buprenorphine or methadone), an ICD-10 F11 diagnosis for a mental and behavioural disorder due to opioid use, or an ICD-10 T40 diagnosis for opioid poisoning. We calculated adjusted hazard ratios (aHR) for factors associated with OUD, estimated the cumulative incidence of opioid agonist use after receiving an ICD-10 F11 diagnosis, and examined excess mortality among beneficiaries with OUD.

“Results: Of 1,251,458 beneficiaries, 1,313 (0.1%) had OUD. Between 2011 and 2020, the incidence of OUD increased by 12% (95% CI 9%-14%) per year. Men, young adults in their twenties, and beneficiaries with co-morbid mental health or other substance use disorders were at increased risk of OUD. The cumulative incidence of opioid agonist use was 10.6% (95% CI 8.3-13.2) at 3 years after receiving an F11 diagnosis. After adjusting for age, sex, year, medical insurance coverage, and population group, OUD was associated with an increased risk of mortality (aHR 2.29, 95% CI 1.85-2.82). OUD was associated with a 7.63-year shorter life expectancy (95% CI 4.08-10.70).

“Conclusions: The incidence of patients diagnosed with or treated for OUD in the private sector is increasing rapidly. People with OUD in the private sector are a vulnerable population with substantial psychiatric comorbidity who often die prematurely. Evidence-based management of OUD is urgently needed to improve the health outcomes of people with OUD.”

This preprint has not been peer-reviewed.

For more information on this research see: http://medrxiv.org/content/10.1101/2022.04.28.22274253v1

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