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Patterns of patient discontinuation from buprenorphine/naloxone treatment for opioid use disorder: A study of a commercially insured population in Massachusetts.
- Source :
-
Journal of substance abuse treatment [J Subst Abuse Treat] 2021 Dec; Vol. 131, pp. 108416. Date of Electronic Publication: 2021 Apr 20. - Publication Year :
- 2021
-
Abstract
- Background: Research has shown buprenorphine/naloxone to be an effective medication for treating individuals with opioid use disorder. At the same time, treatment discontinuation rates are reportedly high though much of the extant evidence comes from studies of the Medicaid population.<br />Objectives: To examine the pattern and determinants of buprenorphine/naloxone treatment discontinuation in a population of commercially insured individuals.<br />Research Design: We performed a retrospective observational analysis of Massachusetts All Payer Claims Data (MA APCD) covering years 2013 through 2017. We defined treatment discontinuation as a gap of 60 consecutive days without a prescription for buprenorphine/naloxone within a time frame of 24 months from the initiation of treatment. A mixed-effect Cox proportional hazard model examined the associated risk of discontinuing treatment with baseline predictors.<br />Subjects: A total of 5134 individuals who were commercially insured during the study period.<br />Measures: Buprenorphine/naloxone treatment discontinuation.<br />Results: Overall 75% of individuals had discontinued treatment within two years of initiating treatment, and median time to discontinuation was 300 days. Patients aged between 18 and 24 years (HR = 1.436, 95%, CI = 1.240-1.663) and receiving treatment from prescribers with high panel-size (HR = 1.278, 95% CI = 1.112-1.468) had higher risk of discontinuing treatment. On the contrary, patients receiving treatment from multiple prescribers had lower associated risk of treatment discontinuation.<br />Conclusions: A substantial percentage of patients discontinue treatment well before they can typically meet criteria for sustained remission. Further investigations should assess the clinical outcomes following premature discontinuation and identify strategies for retaining patients in treatment.<br /> (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Analgesics, Opioid therapeutic use
Buprenorphine, Naloxone Drug Combination therapeutic use
Humans
Massachusetts
Narcotic Antagonists therapeutic use
Opiate Substitution Treatment
Retrospective Studies
United States
Young Adult
Buprenorphine therapeutic use
Opioid-Related Disorders drug therapy
Opioid-Related Disorders epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-6483
- Volume :
- 131
- Database :
- MEDLINE
- Journal :
- Journal of substance abuse treatment
- Publication Type :
- Academic Journal
- Accession number :
- 34098294
- Full Text :
- https://doi.org/10.1016/j.jsat.2021.108416