Improved treatment-retention for patients receiving methadone dosing within the clinic providing physician and other health services (onsite) versus dosing at community (offsite) pharmacies

•Clinic-Pharmacy collaboration has a profound impact on treatment retention.•Collaborating pharmacy patients were four-fold more likely to be retained in care.•Use of a collaborating pharmacy should be encouraged in early stages of care. Opioid-use disorder has been declared a public health crisis a...

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Bibliographic Details
Published in:Drug and alcohol dependence 2018-10, Vol.191, p.1-5
Main Authors: Gauthier, Graham, Eibl, Joseph K., Marsh, David C.
Format: Article
Language:English
Subjects:
Addiction
Addictive behaviors
Cohort analysis
Collaborative care
Community
Dosage
Drug addiction
Drug administration
Harm reduction
Health services
Methadone
Methadone maintenance
Onsite
Opioid agonist therapy
Opioids
Patient satisfaction
Patients
Pharmacies
Pharmacy
Pharmacy dispensing
Prescription drugs
Public health
Quality of care
Retention
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Summary:•Clinic-Pharmacy collaboration has a profound impact on treatment retention.•Collaborating pharmacy patients were four-fold more likely to be retained in care.•Use of a collaborating pharmacy should be encouraged in early stages of care. Opioid-use disorder has been declared a public health crisis across North America. One of the most common treatments for opioid-use disorder is opioid agonist therapy, including MMT. This study examined the impact of methadone dispensing in clinic (onsite) pharmacies versus community (offsite) pharmacies on treatment retention for patients initiating MMT. We conducted a cohort study of 3743 patients who initiated MMT between 2011 and 2012 across a network of 43 MMT clinics in Ontario, Canada. Patients were grouped by level of collaboration between the clinic and the pharmacy that they most frequented over the course of their treatment window. The primary outcome was continuous retention in treatment as measured by opioid agonist dosing records between patients with clinic (onsite) pharmacy dosing versus community (offsite) pharmacy dosing. Of the 3743 patients identified, those who filled their methadone prescriptions at onsite pharmacies were 77.0% less likely to withdraw from treatment before one year (n = 2605; aHR = 0.230; CI95% = (0.210, 0.253); p 
ISSN:0376-8716
1879-0046
DOI:10.1016/j.drugalcdep.2018.04.029