Christina S Lee1, Jane M Liebschutz2,3, Bradley J Anderson4, Michael D Stein4,5. 1. Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts. 2. Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts. 3. Boston University School of Medicine, Boston, Massachusetts. 4. Department of Behavioral Medicine, Butler Hospital, Providence, Rhode Island. 5. Boston University School of Public Health, Boston, Massachusetts.
Abstract
OBJECTIVES: Few studies have explored predictors of entry into and retention in buprenorphine treatment following linkage from an acute medical hospitalization. METHODS: This secondary analysis of a completed clinical trial focuses on medically hospitalized, opioid-dependent patients (n = 72) who were randomized to an intervention including buprenorphine induction and dose stabilization during hospitalization followed by post-discharge transition to office-based buprenorphine treatment (OBOT). Predictors included demographics, days hospitalized, prior buprenorphine/methadone treatment, PTSD symptoms, social support, and readiness for drug use cessation. Outcome variables were treatment entry and retention (number of days in OBOT). RESULTS: Previous buprenorphine treatment, more days hospitalized, and higher PTSD symptoms predicted OBOT entry. Prior treatment, older age, and non-minority status were associated with a higher mean number of days in OBOT. CONCLUSIONS: OBOT may appeal to patients who have tried buprenorphine in other settings. Linking hospitalized patients to OBOT may improve utilization of addiction treatment. SCIENTIFIC SIGNIFICANCE: Prior substance treatment, longer hospital stay, and mental health should be examined in future linkage studies. (Am J Addict 2017;26:667-672).
RCT Entities:
OBJECTIVES: Few studies have explored predictors of entry into and retention in buprenorphine treatment following linkage from an acute medical hospitalization. METHODS: This secondary analysis of a completed clinical trial focuses on medically hospitalized, opioid-dependent patients (n = 72) who were randomized to an intervention including buprenorphine induction and dose stabilization during hospitalization followed by post-discharge transition to office-based buprenorphine treatment (OBOT). Predictors included demographics, days hospitalized, prior buprenorphine/methadone treatment, PTSD symptoms, social support, and readiness for drug use cessation. Outcome variables were treatment entry and retention (number of days in OBOT). RESULTS: Previous buprenorphine treatment, more days hospitalized, and higher PTSD symptoms predicted OBOT entry. Prior treatment, older age, and non-minority status were associated with a higher mean number of days in OBOT. CONCLUSIONS: OBOT may appeal to patients who have tried buprenorphine in other settings. Linking hospitalized patients to OBOT may improve utilization of addiction treatment. SCIENTIFIC SIGNIFICANCE: Prior substance treatment, longer hospital stay, and mental health should be examined in future linkage studies. (Am J Addict 2017;26:667-672).
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