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Long-term retention in Office Based Opioid Treatment with buprenorphine.
- Source :
-
Journal of substance abuse treatment [J Subst Abuse Treat] 2017 Mar; Vol. 74, pp. 65-70. Date of Electronic Publication: 2016 Dec 30. - Publication Year :
- 2017
-
Abstract
- Background: Guidelines recommend long-term treatment for opioid use disorder with buprenorphine; however, little is known about patients in long-term treatment. The aim of this study is to examine the prevalence and patient characteristics of long-term treatment retention (≥1year) in an Office Based Opioid Treatment (OBOT) program with buprenorphine.<br />Methods: This is a retrospective cohort study of adults on buprenorphine from January 2002 to February 2014 in a large urban safety-net primary care OBOT program. The primary outcome was retention in OBOT for at least one continuous year. Potential predictors included age, race, psychiatric diagnoses, hepatitis C, employment, prior buprenorphine, ever heroin use, current cocaine, benzodiazepine and alcohol use on enrollment. Factors associated with ≥1year OBOT retention were identified using generalized estimating equation logistic regression models. Patients who re-enrolled in the program contributed repeated observations.<br />Results: There were 1605 OBOT treatment periods among 1237 patients in this study. Almost half, 45% (717/1605), of all treatment periods were ≥1year and a majority, 53.7% (664/1237), of patients had at least one ≥1year period. In adjusted analyses, female gender (Adjusted Odds Ratio [AOR] 1.55, 95% CI [1.20, 2.00]) psychiatric diagnosis (AOR 1.75 [1.35, 2.27]) and age (AOR 1.19 per 10year increase [1.05, 1.34]) were associated with greater odds of ≥1year retention. Unemployment (AOR 0.72 [0.56, 0.92]), Hepatitis C (AOR 0.59 [0.45, 0.76]), black race/ethnicity (AOR 0.53 [0.36, 0.78]) and Hispanic race/ethnicity (AOR 0.66 [0.48, 0.92]) were associated with lower odds of ≥1year retention.<br />Conclusions: Over half of patients who presented to Office Based Opioid Treatment with buprenorphine were ultimately successfully retained for ≥1year. However, significant disparities in one-year treatment retention were observed, including poorer retention for patients who were younger, black, Hispanic, unemployed, or with hepatitis C.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Age Factors
Female
Humans
Male
Middle Aged
Primary Health Care statistics & numerical data
Retrospective Studies
Safety-net Providers statistics & numerical data
Sex Factors
Young Adult
Analgesics, Opioid therapeutic use
Buprenorphine therapeutic use
Opiate Substitution Treatment statistics & numerical data
Opioid-Related Disorders drug therapy
Outpatients statistics & numerical data
Patient Dropouts statistics & numerical data
Urban Population statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1873-6483
- Volume :
- 74
- Database :
- MEDLINE
- Journal :
- Journal of substance abuse treatment
- Publication Type :
- Academic Journal
- Accession number :
- 28132702
- Full Text :
- https://doi.org/10.1016/j.jsat.2016.12.010