Louise Durand

Biostatistician and healthcare data enthusiast, Louise is currently a researcher at the Royal College of Surgeons in Ireland (RCSI) working on opioid agonist treatment (OAT).


Impact of the COVID-19 pandemic on opioid agonist treatment (OAT) in Ireland: An interrupted time series analysis


Aims
This study aims to assess the impact of the national contingency guidelines, developed in response to COVID-19, on the quality of OAT care delivered in Ireland.

Methods
An interrupted time series design was used with anonymised aggregated level data from the national OAT register. Separate segmented regressions were conducted to estimate the impact of the national contingency guidelines on the following outcomes: (1) number of patients in treatment; (2) number of patients starting OAT; and (3) number of patients dropping out of treatment. The study period was divided into pre-(March 2019 to February 2020) and post- intervention (April 2020 to March 2021) segments. Immediate (change in level) and longer-term impacts (change in slope) of changes to provision of OAT in each of the outcomes were investigated. Regression coefficients (β) and 95% confidence intervals (CIs) are reported.

Preliminary results
Significant changes in level (β2=504, 95% CI: 441 – 567) and slope (β3=32, 95% CI: 24 – 39) were observed for number of patients in OAT following the introduction of contingency guidelines. Large variability was observed for new starts and dropping out of OAT each month, with a peak of +63% between February and April 2020 for new starts, and a corresponding drop of -49% for drop outs. However, no significant changes in level or slope were observed for new starts or dropouts.

Conclusions
COVID-19 contingency guidelines led to a sharp and sustained increase in the number of people receiving OAT in Ireland, with numbers dropping out of treatment remaining largely unchanged.

Presentation video: