PMID- 34780319
OWN - NLM
STAT- MEDLINE
DCOM- 20220726
LR  - 20220805
IS  - 1097-9891 (Electronic)
IS  - 0095-2990 (Linking)
VI  - 48
IP  - 3
DP  - 2022 May 4
TI  - Extended-release buprenorphine outcomes among treatment resistant veterans.
PG  - 334-337
LID - 10.1080/00952990.2021.1992773 [doi]
AB  - Background: Buprenorphine Extended-Release (BUP-XR) is an FDA approved, monthly 
      subcutaneous injection for opioid use disorder. This formulation provides an 
      alternative for patients who have difficulty adhering to daily sublingual 
      buprenorphine; however, its cost may be prohibitive compared to other medication 
      alternatives.Objectives: The objective of this project was to evaluate the 
      effectiveness of BUP-XR and provide a rationale for its utilization in health 
      care facilitates.Methods: Across two VA outpatient clinics, twenty-six (22 male, 
      4 female) clinically complex patients received at least one BUP-XR injection 
      between December 1, 2018 and April 1, 2020. The sample was high risk for hospital 
      admission and mortality. Data was collected retrospectively from the medical 
      records. Outcomes examined included: medication adherence, urine drug and alcohol 
      screenings, emergency department visits, hospital admissions, and housing status. 
      Within-subject comparisons were made between the six month period prior to and 
      following the first injection.Results: Treatment retention was robust, as 81% of 
      the sample received six or more monthly BUP-XR injections. Most patients (77%) 
      maintained 300 mg dosage and a majority (70%) missed or were late for at least 
      one injection. BUP-XR was associated with reduction in: emergency department 
      visits, days of hospitalization, non-prescribed opioid use, and homelessness. 
      Mortality rate was 23%.Conclusions: BUP-XR with a flexible dosing schedule and a 
      nonstandard default dose of 300 mgs resulted in robust retention, provided 
      effective treatment of OUD, and reduced health care utilization for these complex 
      patients with high mortality risk. However, due to the lack of statistical 
      significance generalization of these findings is limited.
FAU - Cotton, Ann J
AU  - Cotton AJ
AUID- ORCID: 0000-0001-7141-4890
AD  - Addiction Treatment Center, U.S. Department of Veterans Affairs Puget Sound 
      Health Care System, Seattle, USA.
AD  - Department of Psychiatry and Behavioral Sciences, University of Washington, 
      Seattle, USA.
FAU - Lo, Katelyn
AU  - Lo K
AD  - Addiction Treatment Center, U.S. Department of Veterans Affairs Puget Sound 
      Health Care System, Seattle, USA.
FAU - Kurtz, Fiona B
AU  - Kurtz FB
AD  - Addiction Treatment Center, U.S. Department of Veterans Affairs Puget Sound 
      Health Care System, Seattle, USA.
AD  - Center of Excellence in Substance Addiction Treatment and Education, Veterans 
      Affairs Puget Sound Health Care System, Seattle, USA.
FAU - Waldbauer, LeAnna
AU  - Waldbauer L
AD  - Addiction Treatment Center, U.S. Department of Veterans Affairs Puget Sound 
      Health Care System, Seattle, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20211115
PL  - England
TA  - Am J Drug Alcohol Abuse
JT  - The American journal of drug and alcohol abuse
JID - 7502510
RN  - 0 (Delayed-Action Preparations)
RN  - 0 (Narcotic Antagonists)
RN  - 40D3SCR4GZ (Buprenorphine)
RN  - 5S6W795CQM (Naltrexone)
SB  - IM
MH  - *Buprenorphine/therapeutic use
MH  - Delayed-Action Preparations/therapeutic use
MH  - Female
MH  - Humans
MH  - Male
MH  - Naltrexone/therapeutic use
MH  - Narcotic Antagonists/therapeutic use
MH  - *Opioid-Related Disorders/drug therapy
MH  - Retrospective Studies
MH  - *Veterans
OTO - NOTNLM
OT  - BUP-XR
OT  - effectiveness
OT  - opioid use disorder
OT  - veterans
EDAT- 2021/11/16 06:00
MHDA- 2022/07/27 06:00
CRDT- 2021/11/15 17:15
PHST- 2021/11/16 06:00 [pubmed]
PHST- 2022/07/27 06:00 [medline]
PHST- 2021/11/15 17:15 [entrez]
AID - 10.1080/00952990.2021.1992773 [doi]
PST - ppublish
SO  - Am J Drug Alcohol Abuse. 2022 May 4;48(3):334-337. doi: 
      10.1080/00952990.2021.1992773. Epub 2021 Nov 15.