{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T05:11:34Z","timestamp":1769317894190,"version":"3.49.0"},"reference-count":55,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T00:00:00Z","timestamp":1620518400000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001823","name":"Ministerstvo \u0160kolstv\u00ed, Ml\u00e1de\u017ee a T\u011blov\u00fdchovy","doi-asserted-by":"publisher","award":["260500"],"award-info":[{"award-number":["260500"]}],"id":[{"id":"10.13039\/501100001823","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003243","name":"Ministerstvo Zdravotnictv\u00ed Cesk\u00e9 Republiky","doi-asserted-by":"publisher","award":["NU20-09-00066"],"award-info":[{"award-number":["NU20-09-00066"]}],"id":[{"id":"10.13039\/501100003243","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007397","name":"Univerzita Karlova v Praze","doi-asserted-by":"publisher","award":["Progress No. Q06\/LF1"],"award-info":[{"award-number":["Progress No. Q06\/LF1"]}],"id":[{"id":"10.13039\/100007397","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,4,16]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Opioid maintenance treatment (OMT) varies across settings and between countries. We plan to use data from several nationwide health and population registers to further improve the knowledge base established from earlier studies. Our aim is to study OMT adherence trajectories and to identify factors associated with improved outcomes for OMT patients across the Czech Republic, Norway and Denmark, in order to further improve OMT and our understanding of the key elements of treatment success.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The registry-based cohort approach across the three countries allows us to link data from a range of registers on the individual level, by using personal identifiers in nationwide cohorts of OMT and non-OMT patients and the general non-using populations. A total of ~21\u2009500 OMT patients over the last two decades in all three countries will be included in the study. The following outcome variables (based on the International Classification of Diseases, 10th Revision codes) will be obtained from relevant registers: treatment adherence to OMT, comorbidity (somatic and mental health), and all-cause and cause-specific mortality. Outcomes of the country-specific analyses will be pooled.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The national OMT cohorts have been approved by the ethics committees in the respective countries. Data will be stored according to national and local guidelines and treated confidentially, and all data will be analysed separately for each country and compared across countries. Findings will be disseminated in peer-reviewed scientific journals, national and international conferences, and in briefings to inform clinical decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-047028","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T14:31:23Z","timestamp":1620657083000},"page":"e047028","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Opioid maintenance treatment in the Czech Republic, Norway and Denmark: a study protocol of a comparative registry linkage study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7672-3753","authenticated-orcid":false,"given":"Roman","family":"Gabrhel\u00edk","sequence":"first","affiliation":[{"name":"Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic"},{"name":"Department of Addictology, General University Hospital in Prague, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marte","family":"Handal","sequence":"additional","affiliation":[{"name":"Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic"},{"name":"Norwegian Institute of Public Health, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viktor","family":"Mrav\u010d\u00edk","sequence":"additional","affiliation":[{"name":"Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blanka","family":"Nechansk\u00e1","sequence":"additional","affiliation":[{"name":"Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic"},{"name":"Department of Addictology, General University Hospital in Prague, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Tjagvad","sequence":"additional","affiliation":[{"name":"Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgitte","family":"Thylstrup","sequence":"additional","affiliation":[{"name":"Centre For Alcohol And Drug Research, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morten","family":"Hesse","sequence":"additional","affiliation":[{"name":"Centre For Alcohol And Drug Research, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakub","family":"Mina\u0159\u00edk","sequence":"additional","affiliation":[{"name":"Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji\u0159\u00ed","family":"Jarkovsk\u00fd","sequence":"additional","affiliation":[{"name":"Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Bukten","sequence":"additional","affiliation":[{"name":"Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Clausen","sequence":"additional","affiliation":[{"name":"Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svetlana","family":"Skurtveit","sequence":"additional","affiliation":[{"name":"Norwegian Institute of Public Health, Oslo, Norway"},{"name":"Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,5,10]]},"reference":[{"key":"2025121513010039000_11.5.e047028.1","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1016\/S0140-6736(19)32229-9","article-title":"Global patterns of opioid use and dependence: harms to populations, interventions, and future action","volume":"394","author":"Degenhardt","year":"2019","journal-title":"Lancet"},{"key":"2025121513010039000_11.5.e047028.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32279-7"},{"key":"2025121513010039000_11.5.e047028.3","unstructured":"Vereinte Nationen . B\u00fcro f\u00fcr Drogenkontrolle und Verbrechensbek\u00e4mpfung. World drug report 2018, 2018."},{"key":"2025121513010039000_11.5.e047028.4","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2017.304132"},{"key":"2025121513010039000_11.5.e047028.5","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-8-43","article-title":"Somatic health among heroin addicts before and during opioid maintenance treatment: a retrospective cohort study","volume":"8","author":"Skeie","year":"2008","journal-title":"BMC Public Health"},{"key":"2025121513010039000_11.5.e047028.6","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1111\/add.14768","article-title":"Comparison of psychiatric comorbidity in treatment\u2010seeking, opioid\u2010dependent patients with versus without chronic pain","volume":"115","author":"Higgins","year":"2020","journal-title":"Addiction"},{"key":"2025121513010039000_11.5.e047028.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2011.03637.x"},{"key":"2025121513010039000_11.5.e047028.8","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1111\/dar.12406","article-title":"Substance use pattern, self-control and social network are associated with crime in a substance-using population","volume":"36","author":"Skjaerv\u00f8","year":"2017","journal-title":"Drug Alcohol Rev"},{"key":"2025121513010039000_11.5.e047028.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61462-6"},{"key":"2025121513010039000_11.5.e047028.10","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2011-000774","article-title":"Quantifying the RR of harm to self and others from substance misuse: results from a survey of clinical experts across Scotland","volume":"2","author":"Taylor","year":"2012","journal-title":"BMJ Open"},{"key":"2025121513010039000_11.5.e047028.11","doi-asserted-by":"publisher","DOI":"10.1159\/000317249"},{"key":"2025121513010039000_11.5.e047028.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.03140.x"},{"key":"2025121513010039000_11.5.e047028.13","doi-asserted-by":"publisher","DOI":"10.1111\/add.12337"},{"key":"2025121513010039000_11.5.e047028.14","unstructured":"World Health Organization . International narcotics control board, United nations office on drugs and crime, editors. guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. Geneva: World Health Organization, 2009: 111."},{"key":"2025121513010039000_11.5.e047028.15","unstructured":"European Monitoring Centre for Drugs and Drug Addiction . Health and social responses to drug problems: a European guide. [online]. LU: Publications Office, 2017. https:\/\/data.europa.eu\/doi\/"},{"key":"2025121513010039000_11.5.e047028.16","unstructured":"European Monitoring Centre for Drugs and Drug Addiction . European drug report 2019: trends and developments [online], 2019. Available: https:\/\/data.europa.eu\/doi\/ [Accessed 17 Aug 2019]."},{"key":"2025121513010039000_11.5.e047028.17","doi-asserted-by":"crossref","DOI":"10.1111\/add.14576","article-title":"Hospitalization of children after prenatal exposure to opioid maintenance therapy during pregnancy: a national registry study from the Czech Republic","volume":"114","author":"Skurtveit","year":"2019","journal-title":"Addiction"},{"key":"2025121513010039000_11.5.e047028.18","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1111\/add.14192","article-title":"Neonatal outcomes after fetal exposure to methadone and buprenorphine: national registry studies from the Czech Republic and Norway","volume":"113","author":"Nechansk\u00e1","year":"2018","journal-title":"Addiction"},{"key":"2025121513010039000_11.5.e047028.19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1005359"},{"key":"2025121513010039000_11.5.e047028.20","doi-asserted-by":"crossref","unstructured":"Bukten A , Stavseth MR , Clasuen T . From restrictive to more liberal: variations in mortality among patients in opioid maintenance treatment over a 12-year period. BMC Health Serv Res 2019;19 https:\/\/bmchealthservres.biomedcentral.com\/articles\/ doi:10.1186\/s12913-019-4382-9","DOI":"10.1186\/s12913-019-4382-9"},{"key":"2025121513010039000_11.5.e047028.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2007.11.003"},{"key":"2025121513010039000_11.5.e047028.22","doi-asserted-by":"crossref","unstructured":"Connock M , Juarez-Garcia A , Jowett S , et al . Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess 2007;11 https:\/\/www.journalslibrary.nihr.ac.uk\/hta\/hta11090\/ doi:10.3310\/hta11090","DOI":"10.3310\/hta11090"},{"key":"2025121513010039000_11.5.e047028.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.05.021"},{"key":"2025121513010039000_11.5.e047028.24","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1007\/s10654-017-0342-z","article-title":"A cross-national analysis of the association between years of implementation of opioid substitution treatments and drug-related deaths in Europe from 1995 to 2013","volume":"33","author":"Marotta","year":"2018","journal-title":"Eur J Epidemiol"},{"key":"2025121513010039000_11.5.e047028.25","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1550"},{"key":"2025121513010039000_11.5.e047028.26","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jsat.2018.03.001","article-title":"Effects of medication assisted treatment (MAT) for opioid use disorder on functional outcomes: a systematic review","volume":"89","author":"Maglione","year":"2018","journal-title":"J Subst Abuse Treat"},{"key":"2025121513010039000_11.5.e047028.27","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1016\/j.addbeh.2014.05.007","article-title":"Factors associated with dropout among patients in opioid maintenance treatment (OMT) and predictors of re-entry. A national registry-based study","volume":"39","author":"Bukten","year":"2014","journal-title":"Addict Behav"},{"key":"2025121513010039000_11.5.e047028.28","doi-asserted-by":"crossref","DOI":"10.1186\/s12954-021-00473-9","article-title":"Retention in the Austrian opioid agonist treatment system: a national prospective cohort study","volume":"18","author":"Busch","year":"2021","journal-title":"Harm Reduct J"},{"key":"2025121513010039000_11.5.e047028.29","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1159\/000490529","article-title":"Long-term opioid agonist treatment participation after first treatment entry is similar across 4 European regions but lower in Non-Nationals","volume":"24","author":"Nordt","year":"2018","journal-title":"Eur Addict Res"},{"key":"2025121513010039000_11.5.e047028.30","doi-asserted-by":"crossref","first-page":"248","DOI":"10.21101\/cejph.a4474","article-title":"A unique opportunity to study short- and long-term consequences in children prenatally exposed to illicit drugs and opioid maintenance treatment using Czech and Scandinavian registers","volume":"24","author":"Gabrhel\u00edk","year":"2016","journal-title":"Cent Eur J Public Health"},{"key":"2025121513010039000_11.5.e047028.31","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1056\/NEJMp1802197","article-title":"Assessing drug safety in children \u2014 the role of real-world data","volume":"378","author":"McMahon","year":"2018","journal-title":"N Engl J Med"},{"key":"2025121513010039000_11.5.e047028.32","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1002\/pds.5088","article-title":"In utero opioid exposure and risk of infections in childhood: a multinational Nordic cohort study","volume":"29","author":"Mahic","year":"2020","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2025121513010039000_11.5.e047028.33","first-page":"53","article-title":"Substitu\u010dn\u00ed L\u00e9\u010dba Z\u00e1vislosti Na Opioidech V \u010cR: Kritick\u00fd Pohled","volume":"115","author":"Mravcik","year":"2019","journal-title":"\u010ces a slov Psychiat"},{"key":"2025121513010039000_11.5.e047028.34","doi-asserted-by":"crossref","DOI":"10.1186\/s12954-018-0268-0","article-title":"The complex relation between access to opioid agonist therapy and diversion of opioid medications: a case example of large-scale misuse of buprenorphine in the Czech Republic","volume":"15","author":"Mravc\u00edk","year":"2018","journal-title":"Harm Reduct J"},{"key":"2025121513010039000_11.5.e047028.35","doi-asserted-by":"publisher","DOI":"10.1159\/000097935"},{"key":"2025121513010039000_11.5.e047028.36","unstructured":"European Monitoring Centre for Drugs and Drug Addiction . European drug report 2020: trends and developments [online]. LU: Publications Office, 2020. https:\/\/data.europa.eu\/doi\/10.2810\/420678"},{"key":"2025121513010039000_11.5.e047028.37","unstructured":"European Monitoring Centre for Drugs and Drug Addiction . Denmark country overview, 2016. Available: https:\/\/www.emcdda.europa.eu\/node\/2580_ro#treatmentResponses [Accessed 20 Oct 2020]."},{"key":"2025121513010039000_11.5.e047028.38","unstructured":"Sundhedsstyrelsen . Evaluering AF ordning Med l\u00e6geordineret heroin TIL stofmisbrugere 2010-2012 2013."},{"key":"2025121513010039000_11.5.e047028.39","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1177\/145507251002700604","article-title":"Shifting focus in substitution treatment in the Nordic countries","volume":"27","author":"Skretting","year":"2010","journal-title":"Nord Stud Alcohol Drugs"},{"key":"2025121513010039000_11.5.e047028.40","unstructured":"Sundhedsstyrelsen . Vejledning TIL l\u00e6ger, Der behandler opioidafh\u00e6ngige patienter Med substitutionsmedicin: lovkrav OG anbefalinger. Sundhedsstyrelsen 2017."},{"key":"2025121513010039000_11.5.e047028.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.10.014"},{"key":"2025121513010039000_11.5.e047028.42","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-7843.2009.00494.x"},{"key":"2025121513010039000_11.5.e047028.43","doi-asserted-by":"crossref","DOI":"10.1002\/pds.638","article-title":"Conducting pharmacoepidemiologic research in Denmark","volume":"10","author":"Hallas","year":"2001","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2025121513010039000_11.5.e047028.44","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9930-3"},{"key":"2025121513010039000_11.5.e047028.45","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S91125"},{"key":"2025121513010039000_11.5.e047028.46","doi-asserted-by":"crossref","first-page":"768","DOI":"10.4045\/tidsskr.14.1065","article-title":"Datakvaliteten i\u00a0D\u00f8ds\u00e5rsaksregisteret","volume":"135","author":"Pedersen","year":"2015","journal-title":"Tidsskriftet"},{"key":"2025121513010039000_11.5.e047028.47","unstructured":"Sundhedsstyrelsen . Stofmisbrugsbehandling \u2013 eftersp\u00f8rgsel og tilg\u00e6ngelighed. Narkotikasituationen i Danmark - delrapport 3 [online]. Sundhedsstyrelsen, 2020. https:\/\/www.sst.dk\/-\/media\/Udgivelser\/2020\/Narkotikasituationen\/Narkorapporten-03.ashx?la=da&hash=1E075F4218C3B4CA2E3B38A28D9B56B6D2BB428C"},{"key":"2025121513010039000_11.5.e047028.48","article-title":"The mortality after release from incarceration Consortium (MARIC): protocol for a multi-national, individual participant data meta-analysis","volume":"5","author":"Borschmann","year":"2020","journal-title":"Int J Popul Data Sci"},{"key":"2025121513010039000_11.5.e047028.49","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60994-5"},{"key":"2025121513010039000_11.5.e047028.50","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c221"},{"key":"2025121513010039000_11.5.e047028.51","unstructured":"Rothman KJ , Greenland S , Lash TL . Modern epidemiology. 3rd edn. Philadelphia, Baltimore, New York: Wolters Kluwer Health, Lippincott Williams & Wilkins, 2008: 758."},{"key":"2025121513010039000_11.5.e047028.52","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"2025121513010039000_11.5.e047028.53","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1159\/000446429","article-title":"Methadone-related overdose deaths in a liberal opioid maintenance treatment programme","volume":"22","author":"Tjagvad","year":"2016","journal-title":"Eur Addict Res"},{"key":"2025121513010039000_11.5.e047028.54","doi-asserted-by":"crossref","DOI":"10.1016\/j.drugalcdep.2020.107933","article-title":"Socioeconomic characteristics of women with substance use disorder during pregnancy and neonatal outcomes in their newborns: a national registry study from the Czech Republic","volume":"209","author":"Mravc\u00edk","year":"2020","journal-title":"Drug Alcohol Depend"},{"key":"2025121513010039000_11.5.e047028.55","doi-asserted-by":"crossref","DOI":"10.1186\/s13011-018-0177-y","article-title":"Comorbid opioid use is undertreated among forensic patients with schizophrenia","volume":"13","author":"Kivimies","year":"2018","journal-title":"Subst Abuse Treat Prev Policy"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-047028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T21:01:12Z","timestamp":1765832472000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-047028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":55,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,10]]},"published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1136\/bmjopen-2020-047028"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-047028","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}