Dissertations, Theses, and Capstone Projects

Date of Degree

9-2022

Document Type

Dissertation

Degree Name

Ph.D.

Program

Nursing

Advisor

Martha Velasco-Whetsell

Committee Members

Juan Battle

Steven L Baumann

Callista Roy

Subject Categories

Psychiatric and Mental Health Nursing | Public Health and Community Nursing

Keywords

opioid use disorder, treatment retention, biomarker, socio-demographic factors

Abstract

ABSTRACT

Biomarker, Treatment, and Socio-Demographic Factors

Affecting Opioid Use Disorder Treatment Retention

by

Fernand A. De Los Reyes

Advisor: Martha Velasco-Whetsell

Increasing mortality from opioid overdose and low treatment engagement are significant public health concerns. Along with increasing health care and criminal justice enforcement costs, there is an urgent need to study the factors associated with treatment retention in opioid use disorder. The study investigated the relative impact of the biomarker cholesterol on treatment retention in an opioid treatment program (OTP) clinic. Further, it examined the medical comorbidities, treatment, and socio-demographic variables that impact opioid use disorder treatment retention. This study was a secondary analysis of patient health records (n=267) in an opioid treatment program clinic. The study employed a hierarchical logistic regression of three models to test the relationship of treatment retention with a cholesterol biomarker, treatment, and socio-demographic factors. This study finds that cholesterol affects positively and significantly opioid treatment retention across three domains. As a stand-alone independent variable in the biomarker domain, Model I, cholesterol level positively impacts treatment retention (p =0.009). Similarly, an increase in the cholesterol level of patients results in an increase in treatment retention. In the treatment factor domain, Model II, the total cholesterol level (p= 0.025) and medication dosage (p= 0.003) continue to support a significantly positive relation to the dependent variable, treatment retention.

Further, with the third domain’s socio-demographic variables, medical comorbidities cease to be statistically significant. Cholesterol level in Model III remains a positive predictor of treatment retention in opioid abuse treatment (p= 0.026). Age and gender are not statistically significant in predicting treatment retention. Regarding ethnicity, this study unequivocally supports that Blacks stay in treatment more than their White counterparts at the study location (p= 0.006; OR= 2.741). This study supports the idea that providing integrated health services in an inclusive OTP clinic promotes the retention of a minority patient population. Additionally, this study supports the extensive use of nursing theories such as the Roy Adaptation Model to generate new knowledge in improving health outcomes, promoting inclusion and equity, and reversing health disparities.

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