The association between buprenorphine doses above 16 milligrams and treatment retention in a multi‐payer national sample in the United States, 2014 to 2021.
Background and Aims: Buprenorphine‐naloxone reduces overdose deaths in people with opioid use disorder (OUD). Treatment retention increases with higher daily doses. No national studies exist on retention's association with 24, 32 and 40 mg. This study aimed to: (1) estimate the effect on treatment r...
| Publicado en: | Addiction Vol. 120; no. 6; pp. 1198 - 1207 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2025
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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=184927592&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 184927592 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Jun2025 vid: 120 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 184927592 183788158 184927592 184927592 10.1111/add.70002 184927592 ppf: 1198 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: The association between buprenorphine doses above 16 milligrams and treatment retention in a multi‐payer national sample in the United States, 2014 to 2021. aug: au: Stringfellow, Erin J. Dong, Huiru Khatami, Seyedeh Nazanin Lee, Hannah Jalali, Mohammad S. affil: Massachusetts General Hospital Institute for Technology Assessment, Harvard Medical School, Boston MA, , USA sug: subj: Buprenorphine Administration and Dosage Naloxone Administration and Dosage Treatment Outcomes Evaluation Dose-Response Relationship, Drug Substance Use Disorders Drug Therapy Human United States Funding Source Drug Therapy, Combination Nonexperimental Studies Prospective Studies Descriptive Statistics Male Female Adult Odds Ratio Confidence Intervals Adult: 19-44 years Male Female ab: Background and Aims: Buprenorphine‐naloxone reduces overdose deaths in people with opioid use disorder (OUD). Treatment retention increases with higher daily doses. No national studies exist on retention's association with 24, 32 and 40 mg. This study aimed to: (1) estimate the effect on treatment retention of buprenorphine‐naloxone doses between 4 and 40 mg compared with 16; and (2) compare the effect on treatment retention of 24, 32 and 40 mg doses. Design: Observational cohort study in a national, multi‐payer sample of prescription claims (IQVIA) of episodes involving buprenorphine‐naloxone for OUD. Incident episodes started between 1 January 2014 and 31 March 2020, with a washout of 180 days. New episodes started with a 14+ day gap between prescriptions. Setting: United States of America. Participants: The sample involved 620 229 episodes across 498 879 patients [42.3% female; mean age 37.9 (standard deviaion: 11.9)] who were dispensed prescriptions of buprenorphine‐naloxone for OUD. Measurements The exposure was the maximum daily dose of buprenorphine‐naloxone reached in the first 30 days of an episode, ranging from 4 to 40 mg. The outcome, treatment retention, was defined as having an active prescription at 1, 3, 6, 12, or 18 months. Covariates were age, sex, race and ethnicity, primary payer, and year of episode initiation. Findings Daily doses of 24, 32 and 40 mg increased retention compared with 16 mg at 1–18 months [adjusted odds ratio (aOR) range = 1.17; 95% confidence interval (CI) = 1.14, 1.20 at 18 months to 1.52 (CI = 1.49, 1.54) at 1 month, both for 24 mg]. In pairwise comparisons, 32 mg was favorable to 24 mg at 6, 12 and 18 months [aOR = 1.06 (95% CI = 1.02, 1.10) at 6 months; aOR = 1.09 (95% CI = 1.04, 1.14) at 12 months; aOR = 1.12 (95% CI = 1.06, 1.19) at 18 months], and 40 mg was favorable to 24 mg at 12 and 18 months [aOR = 1.10 (95% CI = 1.01, 1.21) at 12 months; aOR = 1.18 (95% CI = 1.06, 1.30) at 18 months]. Conclusions: Daily buprenorphine‐naloxone doses of 24 mg appear to be associated with increased treatment retention compared with 16 mg and, for 6+ month episodes, 32 and 40 mg appear to be associated with increased retention compared with 24 mg. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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