BACKGROUND: This study assesses the rate and predictors of treatment retention for primary care patients with opioid dependence-prescribed buprenorphine, a long-acting partial opioid agonist. METHODS: Observational cohort study of patients prescribed buprenorphine/naloxone and followed for 6 months in the period after the adoption of buprenophine/naloxone by a primary care practice in Rhode Island. Practice policy precluded patient discharges due to continuing drug use. RESULTS: Patients (n=41) had a mean duration of opioid use of 15.7 years and most had a history of heroin use (63.4%). Thirty-nine percent of patients transferred from methadone maintenance. At 24 weeks, 59% remained in treatment. Nearly half of dropouts occurred in the first 30 days. Participants with opiate-positive toxicologies at week 1 were more likely to drop out of the program (P<.01) and had a significantly shorter retention time (P<.01) on average. Among other drug use and drug treatment variables, employment and addiction counseling during treatment were significantly associated with treatment retention (P=.03). CONCLUSION: Retention rates in a real world, primary care-based buprenorphine maintenance practice reflect those reported in clinical trials. Abstinence during the first week of treatment and receipt of counseling were critical to patient retention.
BACKGROUND: This study assesses the rate and predictors of treatment retention for primary care patients with opioid dependence-prescribed buprenorphine, a long-acting partial opioid agonist. METHODS: Observational cohort study of patients prescribed buprenorphine/naloxone and followed for 6 months in the period after the adoption of buprenophine/naloxone by a primary care practice in Rhode Island. Practice policy precluded patient discharges due to continuing drug use. RESULTS:Patients (n=41) had a mean duration of opioid use of 15.7 years and most had a history of heroin use (63.4%). Thirty-nine percent of patients transferred from methadone maintenance. At 24 weeks, 59% remained in treatment. Nearly half of dropouts occurred in the first 30 days. Participants with opiate-positive toxicologies at week 1 were more likely to drop out of the program (P<.01) and had a significantly shorter retention time (P<.01) on average. Among other drug use and drug treatment variables, employment and addiction counseling during treatment were significantly associated with treatment retention (P=.03). CONCLUSION: Retention rates in a real world, primary care-based buprenorphine maintenance practice reflect those reported in clinical trials. Abstinence during the first week of treatment and receipt of counseling were critical to patient retention.
Authors: G Fischer; W Gombas; H Eder; R Jagsch; A Peternell; G Stühlinger; L Pezawas; H N Aschauer; S Kasper Journal: Addiction Date: 1999-09 Impact factor: 6.526
Authors: Jonathan D Savant; Declan T Barry; Christopher J Cutter; Michelle T Joy; An Dinh; Richard S Schottenfeld; David A Fiellin Journal: Drug Alcohol Depend Date: 2012-07-06 Impact factor: 4.492
Authors: Gail D'Onofrio; Marek C Chawarski; Patrick G O'Connor; Michael V Pantalon; Susan H Busch; Patricia H Owens; Kathryn Hawk; Steven L Bernstein; David A Fiellin Journal: J Gen Intern Med Date: 2017-02-13 Impact factor: 5.128
Authors: Emlyn S Jones; Brent A Moore; Jody L Sindelar; Patrick G O'Connor; Richard S Schottenfeld; David A Fiellin Journal: Drug Alcohol Depend Date: 2008-09-19 Impact factor: 4.492