Date de publication
Géographie
Langue de la ressource
Texte disponible en version intégrale
Open Access / OK to Reproduce
Évalué par des pairs
L’objectif
Canadian Opioid Agonist Therapy (OAT) guidelines outline take-home dose (THD) criteria, yet, OAT prescribers use their clinical judgement to decide whether an individual is ‘clinically stable’ to receive THD. This review aims to address the knowledge gap regarding whether these circumstances lead to inequitable access to take home doses, including in the context of the updated COVID-19 guidelines.
Constatations/points à retenir
A total of 56 guidelines and seven academic studies were included. This two-pronged literature review demonstrated that current guidelines likely contribute to inequitable OAT THD access due primarily to inconsistent ‘stability’ criteria across guidelines. More research is needed to understand differential OAT THD access with a focus on prescriber decision-making and evaluating associated treatment and safety outcomes. The development of a client-centered, equity-focused, and evidence-informed decision making framework that incorporates more clear definitions of ‘stability’ criteria and indications for prescriber discretion is warranted.
La conception ou méthodologie de recherche
Available academic literature was searched in Embase, Medline, and PsychINFO up until October 12th, 2022, to identify studies that compared characteristics of individuals on OAT who had and had not been granted access to THD to explore potential inequities in access. Next, all Canadian national and provincial OAT guidelines were identified through a semi-structured grey literature search (conducted between September-October 2022) and extracted all THD ‘stability’ and allowances/timeline criteria to compare against characteristics identified in the literature search. Data from both review arms were synthesized and narratively presented.
