New research suggests that patients who stay on medications to treat opioid use disorder for one year or longer see an increased probability of survival. The new data could be a call for the broader industry to revisit the current minimum standard of treatments for OUD patients.
The authors of the study, published in the scientific journal Addiction, argue that encouraging patients to maintain MOUD treatment for four years will “significantly increase” positive outcomes.
When adhering to MOUD beyond a fourth year, improvements were not statistically significant.
Typically, the standard of care recommends that patients consistently stay on MOUD treatments for at least six months, and in reality, it’s usually even shorter due to adherence difficulties.
“We found the largest marginal gain in probability of six-year survival from an additional year on MOUD appears to occur around two years, as compared to six months on MOUD,” the study authors wrote. “Statistically significant gains continued through approximately four to five years of MOUD retention relative to six-month MOUD retention.”
But changing an industry standard from six months to eight times the recommended length of treatment is unlikely to be an easy feat.
“With 50% to 60% of patients discontinuing MOUD by six months, the current 90% retention goal is already difficult to achieve,” the authors wrote. “If the recommended duration is increased from six months, it may be tempting to conclude that meeting performance standards will only become challenging.”
Engaging patients in shared decision-making and educating them about expected survival time and treatment goals can help break some of those barriers, they suggest.
Researchers evaluated outcomes of U.S. veterans diagnosed with OUD from 19,666 buprenorphine users, 8,675 methadone users and 4,007 extended-release naltrexone users. Across the board, they found that clinically the suggested 6-month minimum duration of MAT treatment is “likely insufficient, regardless of the patient’s individual mortality risk.”
Even if a patient switched the type of MOUD they were taking, the longer they adhered to some MOUD, the higher their survival probabilities were.
Though additional research is needed, the authors conclude that “the current minimum needs to be revisited” when it comes to MOUD standards, and hope the data will be used to “guide discussions on how to optimally choose duration of therapy based on expected survival.”