Sociodemographic and prescribing characteristics that impact long-term retention in buprenorphine treatment for opioid use disorder among a statewide population

Details

• Alternative Title:
  Drug Alcohol Depend
• Personal Author:
  Hallowell, Benjamin D. ; Chambers, Laura C. ; Samuels, Elizabeth A. ; Bratberg, Jeffrey ; McDonald, James ; Nitenson, Adam ; Onyejekwe, Collette ; Beaudoin, Francesca L.
• Description:
  Background and Aims:
  
  Partial opioid agonist medications for opioid use disorder reduce mortality and morbidity, however long-term retention in treatment is challenging. The objective of this study was to identify patient and prescription characteristics associated with long-term buprenorphine treatment retention.
  
  Methods:
  
  We used data from the Rhode Island prescription drug monitoring program to identify residents who initiated buprenorphine treatment and determine if they were retained in long-term buprenorphine treatment 12-months after treatment initiation. Multivariable logistic regression models were used to identify sociodemographic and prescription characteristics associated with long-term buprenorphine retention.
  
  Findings:
  
  During the study period 4898 unique Rhode Island residents initiated buprenorphine treatment, of whom 37.8 % were retained in treatment at 12-months. Demographic factors associated with a higher odds of long-term buprenorphine retention included older age, female sex, Medicaid insurance (vs private), and living closer to the pharmacy where the prescription was filled. Individuals who were prescribed the tablet formulation (aOR: 0.82 [95 % CI 0.72, 0.93]) or received a non-buprenorphine opioid during the follow-up window (aOR: 37 [95 % CI 0.31, 0.44]) had lower odds of long-term treatment at 12-months. Individuals who received at least one day of overlapping benzodiazepine and buprenorphine prescriptions (aOR: 2.00 [95 % CI 1.70, 2.34]) and those given a longer days supply (aOR: 1.26 [95 % CI 1.01, 1.56]) had higher odds of long-term treatment at 12-months. Findings were similar for treatment retention at 6-months in sensitivity analyses.
  
  Conclusions:
  
  These findings highlight several modifiable prescribing practices associated with long-term buprenorphine retention, suggesting that clinicians and public health practitioners can help remove barriers to long-term retention.
  
  
• Keywords:
  Analgesics, Opioid Buprenorphine Female Healthcare Humans Opiate Substitution Treatment Opioid Opioid-Related Disorders Opioid Use Disorder Prescription Drug Monitoring Retention Retrospective Studies United States

  More +
• Source:
  Drug Alcohol Depend. 241:109680
• Pubmed ID:
  36335834
• Pubmed Central ID:
  PMC10193454
• Document Type:
  Journal Article
• Funding:
  P20 GM125507/GM/NIGMS NIH HHSUnited States/ ; R01 CE003149/CE/NCIPC CDC HHSUnited States/ ; R25 MH083620/MH/NIMH NIH HHSUnited States/ ; T32 DA013911/DA/NIDA NIH HHSUnited States/
• Volume:
  241
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:52f9eccf3d1bcb4c2c28d33de3c8dc94b3f5247b3320a186624700a409f1bfa6
• Download URL:
  https://stacks.cdc.gov/view/cdc/128667/cdc_128667_DS1.pdf
• File Type:
  [PDF - 350.80 KB ]