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• W4220874612 endingPage "108770" @default.
• W4220874612 startingPage "108770" @default.
• W4220874612 abstract "Objective Successful retention on buprenorphine improves outcomes for opioid use disorder (OUD); however, we know little about associations between use of non–prescribed buprenorphine (NPB) preceding treatment intake and clinical outcomes. Methods The study conducted observational retrospective analysis of abstracted electronic health record (EHR) data from a multi-state nationwide office-based opioid treatment program. The study observed a random sample of 1000 newly admitted patients with OUD for buprenorphine maintenance (2015–2018) for up to 12 months following intake. We measured use of NPB by mandatory intake drug testing and manual EHR coding. Outcomes included hazards of treatment discontinuation and rates of opioid use. Results Compared to patients testing negative for buprenorphine at intake, those testing positive (59.6%) had lower hazards of treatment discontinuation (HR = 0.52, 95% CI: 0.44, 0.60, p < 0.01). Results were little changed following adjustment for baseline opioid use and other patient characteristics (aHR: 0.60, 95% CI: 0.51, 0.70, p < 0.01). Risk of discontinuation did not significantly differ between patients by buprenorphine source: prescribed v. NPB (reference) at admission (HR = 1.15, 95% CI: 0.90, 1.46). Opioid use was lower in the buprenorphine positive group at admission (25.0% vs. 53.1%, p < 0.0001) and throughout early months of treatment but converged after 7 months for those remaining in care (17.1% vs. 16.5%, p = 0.89). Conclusion NPB preceding treatment intake was associated with decreased hazards of treatment discontinuation and lower opioid use. These findings suggest use of NPB may be a marker of treatment readiness and that buprenorphine testing at intake may have predictive value for clinical assessments regarding risk of early treatment discontinuation." @default.
• W4220874612 created "2022-04-03" @default.
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• W4220874612 date "2022-08-01" @default.
• W4220874612 modified "2023-10-18" @default.
• W4220874612 title "Non–prescribed buprenorphine preceding treatment intake and clinical outcomes for opioid use disorder" @default.
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• W4220874612 doi "https://doi.org/10.1016/j.jsat.2022.108770" @default.
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