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Updated: Jul 13, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Consistent adherence to guidelines improves opioid dependent patients' first year outcomes.

Jodie A Trafton¹, Keith Humphreys, Alex H S Harris

¹Center for Health Care Evaluation, Veterans Affairs and Stanford University Medical Centers, 795 Willow Road (152-MPD), Menlo Park, CA 94025, USA. Jodie.Trafton@va.gov

The Journal of Behavioral Health Services & Research

|July 5, 2007

Summary

Adhering to clinical guidelines for opioid substitution treatment (OST) improves patient outcomes. Clinics with higher guideline adherence saw greater reductions in heroin and cocaine use and better mental health for patients in opioid dependence treatment.

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Last Updated: Jul 13, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Area of Science:

Addiction Medicine
Clinical Psychology
Public Health

Background:

Clinical practice guidelines for opioid substitution treatment (OST) recommend specific methadone dosages and psychosocial services for opioid dependence.
Significant variation exists in real-world OST clinic practices, potentially impacting patient recovery.
Barriers to guideline-concordant care may limit treatment effectiveness and patient outcomes.

Purpose of the Study:

To examine the impact of consistent adherence to OST guideline recommendations.
To evaluate patient outcomes in Veterans Affairs OST clinics with varying levels of guideline adherence.

Main Methods:

The Multisite Opioid Substitution Treatment (MOST) study involved eight Veterans Affairs OST clinics.
Patient substance use and mental health were assessed over the first year of treatment.
Clinic adherence to OST guidelines was evaluated.

Main Results:

All patients showed improvements in substance use during the first year of OST.
Clinics with higher guideline adherence demonstrated greater reductions in heroin and cocaine use.
Patients at more guideline-adherent clinics experienced significant improvements in mental health.

Conclusions:

Consistent adherence to OST clinical guidelines is associated with improved patient outcomes.
Efforts to enhance guideline implementation in OST settings can positively impact recovery.
Optimizing OST delivery through guideline adherence is crucial for managing opioid dependence.