Buprenorphine Use and Courses of Care for Opioid Use Disorder Treatment Within the Veterans Health Administration.
Sponsor
Research reported in this publication was supported by Helping to End Addiction Long-term® Initiative or NIH HEAL Initiative® under award numbers 3UG1DA040316-04S3 and 1UG1DA049444-01. The work was also supported by the National Institute on Drug Abuse (NIDA) Clinical Trials Network. Institutional support for this work occurred from the VA Salt Lake City Health Care System’s Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation (CIN 13-414);
Published In
Drug and Alcohol Dependence
Document Type
Citation
Publication Date
5-2-2023
Abstract
Background Retention of patients in buprenorphine medication treatment for opioid use disorder (B-MOUD) reduces harms associated with opioid use disorder (OUD). We sought to characterize the patients receiving B-MOUD and courses of B-MOUD in a large healthcare system.
Methods We conducted a retrospective, open cohort study of patients with OUD who either did or did not receive B-MOUD courses within the Veterans Health Administration (VHA) from January 2006 through July 2019, using VHA clinical data. We compared patients receiving or not receiving B-MOUD, characterized B-MOUD courses (e.g., length and doses), and examined persistence, across patient characteristics, over time. We used analyses for normally or non-normally distributed continuous variables, categorical data, and persistence over time (Kaplan-Meier persistence curves).
Results We identified 255,726 Veterans with OUD; 40,431 (15.8%) had received 63,929 B-MOUD courses. Compared to patients with OUD without B-MOUD, patients with B-MOUD were younger, more often of white race, and had more co-morbidities. The frequency of new B-MOUD starts and prevalent B-MOUD patients ranged from 1550 and 1989 in 2007 to 8146 and 16,505 in 2018, respectively. The median duration of B-MOUD was 157 (IQR: 37–537) days for all courses and 33.8% patients had more than one course. The average proportion days covered was 90% (SD: 0.15), and the average prescribed daily dose was 13.44 (SD: 6.5).
Conclusions Within a VHA B-MOUD cohort, courses increased more than 10-fold from 2006 to 2016 with nearly half of patients experiencing multiple courses. Patient demographics seem to dictate the length of courses.
Rights
Copyright © 2023 Elsevier
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DOI
10.1016/j.drugalcdep.2023.109902
Persistent Identifier
https://pdxscholar.library.pdx.edu/sph_facpub/532/
Publisher
Elsevier
Citation Details
Gordon, A. J., Saxon, A. J., Kertesz, S., Wyse, J. J., Manhapra, A., Lin, L. A., ... & Sauer, B. C. (2023). Buprenorphine Use and Courses of Care for Opioid Use Disorder Treatment Within the Veterans Health Administration. Drug and Alcohol Dependence, 109902.