Buprenorphine use and courses of care for opioid use disorder treatment within the Veterans Health Administration

被引:11
|
作者
Gordon, Adam J. [1 ,2 ]
Saxon, Andrew J. [3 ,4 ]
Kertesz, Stefan [5 ,6 ]
Wyse, Jessica J. [7 ,8 ]
Manhapra, Ajay [9 ]
Lin, Lewei A. [10 ,11 ]
Chen, Wei [1 ,2 ]
Hansen, Jared [1 ,2 ]
Pinnell, Derek [1 ,2 ]
Huynh, Tina [1 ,2 ]
Baylis, Jacob D. [1 ,2 ]
Cunningham, Francesca E. [12 ]
Ghitza, Udi E. [13 ]
Bart, Gavin [14 ]
Yu, Hong [15 ,16 ,17 ]
Sauer, Brian C. [1 ,2 ]
机构
[1] Univ Utah, Dept Internal Med, Sch Med, Salt Lake City, UT USA
[2] VA Salt Lake City Hlth Care Syst, Informat Decis Enhancement & Analyt Sci IDEAS Ctr, Salt Lake City, UT USA
[3] Univ Washington, Dept Psychiat & Behav Sci, Sch Med, Seattle, WA USA
[4] VA Puget Sound Hlth Care Syst, Ctr Excellence Subst Addict Treatment & Educ CESA, Seattle, WA USA
[5] Birmingham Vet Affairs Hlth Care Syst, Birmingham, AL USA
[6] Heersink UAB Sch Med, Dept Med, Birmingham, AL USA
[7] VA Portland Hlth CareSyst, Ctr Improve Vet Involvement Care CIVIC, Portland, OR USA
[8] Portland State Univ, Oregon Hlth & Sci Univ, Sch Publ Hlth, Portland, OR USA
[9] Hampton VA Med Ctr, Dept Phys Med & Rehabil Serv, Sect Pain Med, Hampton, VA USA
[10] VA Ann Arbor Healthcare Syst, VA Ctr Clin Management Res CCMR, Ann Arbor, MI USA
[11] Univ Michigan, Dept Psychiat, Ann Arbor, MI USA
[12] Dept Vet Affairs Pharm Benefits Management Serv, Hines, IL USA
[13] NIDA, Ctr Clin Trials Network CCTN, Bethesda, MD USA
[14] Univ Minnesota, Hennepin Healthcare, Med Sch, Minneapolis, MN USA
[15] Univ Massachusetts, Ctr Biomed & Hlth Res Data Sci, Lowell, MA USA
[16] Univ Massachusetts, Miner Sch Comp & Informat Sci, Lowell, MA USA
[17] VA Bedford Healthcare Syst, Ctr Healthcare Org & Implementat Res, Bedford, MA USA
关键词
USA; Opioid-Related Disorders; Buprenorphine; QUALITY-OF-LIFE; METHADONE-MAINTENANCE TREATMENT; MEDICATION COMPLIANCE; RACIAL-DIFFERENCES; AGONIST TREATMENT; EXPANDING ACCESS; TREATMENT OBOT; OUTCOMES; ASSOCIATION; PAIN;
D O I
10.1016/j.drugalcdep.2023.109902
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
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 BMOUD 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 (KaplanResults: 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 half of patients experiencing multiple courses. Patient demographics seem to dictate the length of courses.
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