Opioid use disorder: script pill count, dose influence buprenorphine adherence

  • J Subst Abuse Treat

  • International Clinical Digest
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Takeaway

  • Patients with opioid use disorder (OUD) who received an initial buprenorphine supply for ≤15 days or an initial daily dose of ≤4 mg were more likely to discontinue treatment.
  • Receiving a ≥16 days’ supply of buprenorphine was associated with reduced risk for adverse events.

Why this matters

  • Although the use of buprenorphine treatment is becoming more common, treatment discontinuation rates are high.

Study design

  • 17,158 individuals who had initiated buprenorphine treatment for OUD were identified.
  • Funding: National Institute of Mental Health; National Institute on Drug Abuse.

Key results

  • 10% of initial prescriptions had a daily dose ≤4 mg; 31%, 27%, 9%, and 33% of prescriptions were for ≤7, 8-15, 16-27, and ≥28 days' supply, respectively.
  • 55% discontinued buprenorphine within 180 days and 13% experienced ≥1 opioid-related event within 360 days.
  • Treatment discontinuation was more likely (P<.01 among individuals who received: style="list-style-type:circle;">
  • a daily dose of ≤4 mg (aOR, 1.79) and
  • an initial prescription for ≤15 days vs ≤28 days (≤7 days: aOR, 1.32; 8-15 days: aOR, 1.22).
  • Adverse events were associated with fewer days' supply (≤7 days: aOR, 1.39; 8-15 days: aOR, 1.37; Pboth <.01 but not daily dose mg p=".57).</li">

    Limitations

    • Findings to be interpreted with caution.
    • Findings may not be generalizable.

    Coauthored with Chitra Ravi, MPharm