Contraception claims by medication for opioid use disorder prescription status among insured women with opioid use disorder, United States, 2018.

Autor: Goyal S; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States; Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, United States., Monsour M; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States., Ko JY; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States., Curtis KM; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States., Whiteman MK; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States., Coy KC; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States; Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States., Cox S; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States., Romero L; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States. Electronic address: eon1@cdc.gov.
Jazyk: angličtina
Zdroj: Contraception [Contraception] 2023 Jan; Vol. 117, pp. 67-72. Date of Electronic Publication: 2022 Oct 12.
DOI: 10.1016/j.contraception.2022.09.129
Abstrakt: Objective(s): To understand how contraception method use differed between women prescribed and not prescribed medications for opioid use disorder (MOUD) among commercially-insured and Medicaid-insured women.
Study Design: IBM Watson Health MarketScan Commercial Claims and Encounters database and the Multi-State Medicaid database were used to calculate the (1) crude prevalence, and (2) adjusted odds ratios (adjusted for demographic characteristics) of using long-acting reversible or short-acting hormonal contraception methods or female sterilization compared with none of these methods (no method) in 2018 by MOUD status among women with OUD, aged 20 to 49 years, with continuous health insurance coverage through commercial insurance or Medicaid for ≥6 years. Claims data was used to define contraception use. Fisher exact test or χ 2 test with a P-value ≤ 0.0001, based on the Holm-Bonferroni method, and 95% confidence intervals were used to determine statistically significant differences for prevalence estimates and adjusted odds ratios, respectively.
Results: Only 41% of commercially-insured and Medicaid-insured women with OUD were prescribed MOUD. Medicaid-insured women with OUD prescribed MOUD had a significantly lower crude prevalence of using no method (71.1% vs 79.0%) and higher odds of using female sterilization (aOR, 1.33; 95% CI: 1.06-1.67 vs no method) than those not prescribed MOUD. Among commercially-insured women there were no differences in contraceptive use by MOUD status and 66% used no method.
Conclusions: Among women with ≥ 6 years of continuous insurance coverage, contraceptive use differed by MOUD status and insurance. Prescribing MOUD for women with OUD can be improved to ensure quality care.
Implications: Only two in five women with OUD had evidence of being prescribed MOUD, and majority did not use prescription contraception or female sterilization. Our findings support opportunities to improve prescribing for MOUD and integrate contraception and MOUD services to improve clinical care among women with OUD.
(Published by Elsevier Inc.)
Databáze: MEDLINE
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