Individuals who have been stabilized on opioid agonist treatment (OAT) are typically granted access to OAT take home doses (THD), and this decision is made by prescribers who must use their discretion and make risk/benefit assessments to determine whether patients are capable of adhering to treatment and have proven social, psychological, economic, and clinical 'stability'. Based on the subjective nature of these assessments, it is likely that inequities exist regarding whom and under what circumstances a patient becomes eligible for OAT THD. Furthermore, potential inequities may have been exacerbated or alleviated during the COVID-19 pandemic due to changes in OAT prescribing guidelines and practices. Based on previous research conducted by OCRINT research members regarding potential inequities in access to OAT THD among particular vulnerable populations, it was postulated that current OAT prescribing guidelines may be contributing to inequitable access of OAT THD. To explore this research question, Dr. Shannon Lange (PI) along with members of the Ontario CRISM Node received a CIHR Planning and Dissemination Grant in June, 2022. This grant facilitated a two-pronged systematic literature review to identify key knowledge gaps pertaining to inequities in access to OAT THD through the following activities:
1) A synthesis of all Canadian national/provincial guidelines on OAT THD
2) A literature review of all available academic literature on inequities in access to OAT THD
The systematic review is undergoing peer review for publication in an academic journal, and associated knowledge translation (KT) materials are being created. Both the review and KT materials will be posted here upon publication.
In addition to the systematic review, the research team established an expert committee of key stakeholders from across Ontario with clinical and lived experience with OAT THD and prescribing practices who engaged in a meeting in May, 2023. The meeting’s purpose was to discuss the review’s findings and identify any major gaps and related work being undertaken in the province by members, as well as formulate plans for a future project grant application. Updates on the expert committee work being done will be posted here.