The impact of medication-assisted treatment for opioid use disorder on congestive heart failure outcomes

Résumé fourni par la source

Congestive heart failure (CHF) and opioid use disorder (OUD) commonly coexist and are major contributors to high healthcare utilization in the United States. Medication assisted treatment (MAT; e.g., buprenorphine and methadone) reduces opioid-related mortality by about 50 %; yet little is known about how OUD treatment impacts CHF outcomes in patients with both CHF and OUD. We examined the impact of MAT (buprenorphine, methadone, and naltrexone) on CHF outcomes in patients diagnosed with OUD and CHF, and which MAT (buprenorphine or methadone) medication is associated with the fewest CHF outcomes. A retrospective cohort study of patients 18 years or older diagnosed with both CHF and OUD was conducted using Optum's de-identified Clinformatics® Data Mart Database. Multivariate logistic regression modeling was used to compared patients who were prescribed MAT to those who were not. The primary outcomes were CHF hospitalizations and CHF emergency department visits. No significant differences in the primary outcomes between the MAT and non-MAT cohorts were observed. In conclusion, the lack of association of MAT with negative CHF outcomes suggest that life-saving MAT can be safely used for OUD treatment in the CHF setting. Opioid use disorder (OUD) and congestive heart failure (CHF) are two prevalent burdens to the United States (US) healthcare system. OUD and CHF are seldom considered in the context of one another. The two most common medication-assisted treatment (MAT) medications used to treat OUD are buprenorphine and methadone. Prior research demonstrated that MAT increases the risk of cardiac arrhythmias. Our study found that MAT does not impact CHF hospitalizations, CHF emergency room visits, or all-cause hospitalizations. Buprenorphine had a lower risk of mortality when compared to methadone among patients with co-occurring CHF and OUD. • Opioid use disorder treatment had no impact on heart failure outcomes. • Buprenorphine had a lower risk of mortality when compared to methadone. • Treatment of opioid use disorder improves mortality among heart failure patients.

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