Postoperative buprenorphine continuation in stabilized buprenorphine patients: A population cohort study.
Background and Aims: Sudden discontinuation of buprenorphine in the treatment of opioid use disorder can increase the risk of subsequent relapse and overdose. Little is known about buprenorphine use in the perioperative period. The aim of this study was to determine the rate of buprenorphine continu...
| Publicado en: | Addiction Vol. 118; no. 10; pp. 1953 - 1965 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=171583256&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 171583256 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Oct2023 vid: 118 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 171583256 164362368 171583256 171583256 10.1111/add.16223 171583256 ppf: 1953 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Postoperative buprenorphine continuation in stabilized buprenorphine patients: A population cohort study. aug: au: Hauck, Tanya S. Ladha, Karim S. Le Foll, Bernard Wijeysundera, Duminda N. Kurdyak, Paul affil: Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto ON,, Canada sug: subj: Buprenorphine Perioperative Care Patient Discharge Surgery, Operative Human Substance Use Disorders Retrospective Design Prospective Studies Logistic Regression Ontario Adolescence Adult Odds Ratio Confidence Intervals Comparative Studies Analgesics, Opioid Descriptive Statistics Funding Source Adolescent: 13-18 years Adult: 19-44 years ab: Background and Aims: Sudden discontinuation of buprenorphine in the treatment of opioid use disorder can increase the risk of subsequent relapse and overdose. Little is known about buprenorphine use in the perioperative period. The aim of this study was to determine the rate of buprenorphine continuation after hospital discharge following surgery and factors associated with continuation. Design: A population‐based retrospective cohort study was conducted using administrative data from Ontario, Canada, between 2012 and 2018. The cohort included individuals on continuous buprenorphine prior to surgery. Logistic regression modeling was used to estimate the association of buprenorphine continuation with demographic, opioid agonist treatment, surgical and health service use factors. Setting: Administrative databases from Institute for Clinical Evaluative Sciences (ICES) were used, which capture the Ontario, Canada, population. The data sets describe physician billing, monitoring of controlled substances and hospital discharges. Participants: Adults (≥ 18 years, n = 2176) had received a buprenorphine/naloxone product continuously for at least 60 days for the treatment of opioid use disorder and subsequently underwent a surgical procedure. Measurements Continuation (versus discontinuation) of buprenorphine prescriptions in the 14 days after surgical discharge was recommended. Exposures included demographic, comorbidity, opioid agonist treatment, surgical and health service use characteristics. Findings About 176 (8.1%) of the 2176 patients discontinued buprenorphine after surgery. Inpatient surgery (versus ambulatory) was associated with reduced odds of continuation, with an unadjusted odds ratio (OR) of 0.17 [95% confidence interval (CI) = 0.12–0.25] and an adjusted OR of 0.16 (95% CI = 0.11–0.23) after accounting for age, sex, rural residence, neighborhood income quintile, Charlson comorbidity index, psychiatric hospitalizations in the past 5 years and recent dispensed supply of buprenorphine (number needed to harm of 6.6). Conclusions: In Ontario, Canada, from 2012 to 2018, most patients receiving continuous preoperative buprenorphine therapy continued buprenorphine use after surgery. Inpatient surgery was a strong predictor of discontinuation compared with ambulatory procedures. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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