Increased Treatment Engagement and Adherence: Flexible Management with Prolonged-Release Buprenorphine in Treatment of Opioid Dependence

Opioid dependence (OD) is effectively treated with well-evidenced regimens including psychosocial and opioid agonist pharmacotherapy. Many do not engage with treatment services; reasons include the burden of mandatory supervision and stigma. Injectable prolonged-release buprenorphine (PRB) offers choice and flexibility in treatment. Experience reported here demonstrates the potential for PRB to enable wider engagement with treatment services. Treatment was successful in patients unable to attend daily observed therapy due to work commitments, unable to use services for fear of stigma, or having not achieved goals on previous attempts with conventional approaches. PRB therapy was clinically successful without withdrawal signs or evidence of use of other drugs. Patient-reported outcomes were positive including maintained ability to work, manageable detoxification experience, and stigma-free treatment. This work provides evidence of PRB benefit in expanding treatment engagement.

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Successful Treatment of Opioid Dependence with Flexible Doses of Injectable Prolonged Release Buprenorphine

Case Reports in Psychiatry ◽

10.1155/2019/9381346 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Oscar D’Agnone

Keyword(s):

Opioid Dependence ◽

Therapeutic Option ◽

Prolonged Release ◽

Clinical Scenarios ◽

Patient Reported ◽

Positive Treatment ◽

The Uk ◽

Flexible Dose ◽

Withdrawal Signs ◽

Injectable Form

Opioid dependence (OD) may be effectively treated with well-evidenced regimens including psychosocial and pharmacotherapeutic interventions. Treatment has benefits but also limitations including risk of diversion, impact of mandatory daily supervision, and stigma. An injectable prolonged release buprenorphine with flexible dose options has recently been approved by the European Commission and is available in the UK and other European Countries. Initial positive treatment experience in patients with different clinical scenarios (patients with no recent treatment history, a transfer from oral methadone, and change from sublingual buprenorphine tablets) provides evidence of the potential benefit in a range of situations for this therapeutic option. Adoption of the injectable form was clinically successful with no withdrawal signs, nor evidence of use of other drugs. Patient reported outcomes were positive including reduction in cravings and anxiety and improved attitude, relationships, and general mood.

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Leveraging Patient Reported Outcomes Measurement via the Electronic Health Record to Connect Patients with Cancer to Smoking Cessation Treatment

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17145034 ◽

2020 ◽

Vol 17 (14) ◽

pp. 5034 ◽

Cited By ~ 1

Author(s):

Julia R. May ◽

Elizabeth Klass ◽

Kristina Davis ◽

Timothy Pearman ◽

Steven Rittmeyer ◽

...

Keyword(s):

Tobacco Use ◽

Patient Reported Outcomes ◽

Tobacco Cessation ◽

Treatment Engagement ◽

Cancer Center ◽

Health Record ◽

Patient Portal ◽

Smoking Cessation Treatment ◽

Cessation Treatment ◽

Patient Reported

Tobacco use negatively impacts cancer treatment outcomes, yet too few providers actively support their patients in quitting. Barriers to consistently addressing tobacco use and referring to treatment include time constraints and lack of knowledge surrounding treatment options. Patient Reported Outcomes (PRO) measurement is best practice in cancer care and has potential to help address these barriers to tobacco cessation treatment. This descriptive program evaluation study reports preliminary results following implementation of a novel automated PRO tobacco use screener and referral system via the electronic health record (EHR) patient portal (MyChart) that was developed and implemented as a part of a population-based tobacco treatment program at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Between 25 June 2019 and 6 April 2020, 4589 unique patients completed the screener and 164 (3.6%) unique patients screened positive for recent (past month) cigarette smoking. All patients who screened positive were automatically referred to a smoking cessation treatment program integrated within the Lurie Cancer Center, and 71 (49.7%) patients engaged in treatment, as defined by completing at least one behavioral counseling session. Preliminary results indicate that the PRO/MyChart system may improve smoker identification and increase offering of treatment and, despite the “cold call” following a positive screen, may result in a treatment engagement rate that is higher than rates of treatment engagement previously documented in oncology settings. Longer term evaluation with formal statistical testing is needed before drawing conclusions regarding effectiveness, but PRO measurement via the EHR patient portal may serve a potentially important role in a multi-component approach to reaching and engaging cancer patients in comprehensive tobacco cessation treatment.

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Renal Function and Patient-Reported Outcomes in Stable Kidney Transplant Patients Following Conversion From Twice-Daily Immediate-Release Tacrolimus to Once-Daily Prolonged-Release Tacrolimus: A 12-Month Observational Study in Routine Clinical Practice in Germany (ADAGIO)

Transplantation Proceedings ◽

10.1016/j.transproceed.2021.01.034 ◽

2021 ◽

Author(s):

Christian Hugo ◽

Horst Weihprecht ◽

Bernhard Banas ◽

Bernd Schröppel ◽

Sabine Jank ◽

...

Keyword(s):

Renal Function ◽

Clinical Practice ◽

Patient Reported Outcomes ◽

Immediate Release ◽

Routine Clinical Practice ◽

Prolonged Release ◽

Once Daily ◽

Transplant Patients ◽

Patient Reported ◽

Kidney Transplant Patients

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Patient-Reported Outcomes of Treatment of Opioid Dependence With Weekly and Monthly Subcutaneous Depot vs Daily Sublingual Buprenorphine

JAMA Network Open ◽

10.1001/jamanetworkopen.2021.9041 ◽

2021 ◽

Vol 4 (5) ◽

pp. e219041

Author(s):

Nicholas Lintzeris ◽

Adrian J. Dunlop ◽

Paul S. Haber ◽

Dan I. Lubman ◽

Robert Graham ◽

...

Keyword(s):

Opioid Dependence ◽

Patient Reported Outcomes ◽

Sublingual Buprenorphine ◽

Patient Reported

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Patient-Reported Outcomes, Experiences and Satisfaction with Weekly and Monthly Injectable Prolonged-Release Buprenorphine

Substance Abuse and Rehabilitation ◽

10.2147/sar.s266838 ◽

2020 ◽

Vol Volume 11 ◽

pp. 41-47

Author(s):

Graham Parsons ◽

Cindy Ragbir ◽

Oscar D’Agnone ◽

Ayana Gibbs ◽

Richard Littlewood ◽

...

Keyword(s):

Patient Reported Outcomes ◽

Prolonged Release ◽

Patient Reported

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Patient-reported outcomes among people receiving opioid agonist therapy and treatment for hepatitis C virus infection: results from CO-STAR

Journal of Hepatology ◽

10.1016/s0168-8278(20)31208-3 ◽

2020 ◽

Vol 73 ◽

pp. S356

Author(s):

Olav Dalgard ◽

Alain Litwin ◽

Gregory Dore ◽

Oren Shibolet ◽

Jason Grebely ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Virus Infection ◽

Patient Reported Outcomes ◽

Hepatitis C Virus Infection ◽

Agonist Therapy ◽

Opioid Agonist ◽

Opioid Agonist Therapy ◽

Patient Reported

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Clinical and Patient-Reported Outcomes of Direct-Acting Antivirals for the Treatment of Chronic Hepatitis C Among Patients on Opioid Agonist Treatment: A Real-world Prospective Cohort Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa317 ◽

2020 ◽

Vol 7 (8) ◽

Author(s):

Bernd Schulte ◽

Christiane S Schmidt ◽

Jakob Manthey ◽

Lisa Strada ◽

Stefan Christensen ◽

...

Keyword(s):

Cohort Study ◽

Hepatitis C ◽

Real World ◽

Patient Reported Outcomes ◽

Direct Acting Antivirals ◽

Hcv Treatment ◽

Opioid Agonist ◽

Patient Reported ◽

Direct Acting ◽

Over Time

Abstract Background Patient-reported outcomes (PROs) can help to reduce uncertainties about hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) among people who inject drugs and increase treatment uptake in this high-risk group. Besides clinical data, this study analyzed for the first time PROs in a real-world sample of patients on opioid agonist treatment (OAT) and HCV treatment with DAAs. Methods HCV treatment data including virological response, adherence, safety, and PROs of 328 German patients on OAT were analyzed in a pragmatic prospective cohort study conducted from 2016 to 2018. Clinical effectiveness was defined as sustained virological response (SVR) at week 12 after end of treatment and calculated in per-protocol (PP) and intention-to-treat (ITT) analyses. Changes over time in PROs on health-related quality of life, physical and mental health, functioning, medication tolerability, fatigue, concentration, and memory were analyzed by repeated-measures analyses of variances (ANOVAs). Results We found high adherence and treatment completion rates, a low number of mainly mild adverse events, and high SVR rates (PP: 97.5% [n = 285]; ITT: 84.5% [n = 328]). Missing SVR data in the ITT sample were mainly caused by patients lost to follow-up after treatment completion. Most PROs showed statistically significant but modest improvements over time, with more pronounced improvements in highly impaired patients. Conclusions This real-world study confirms that DAA treatment among OAT patients is feasible, safe, and effective. PROs show that all patients, but particularly those with higher somatic, mental, and social burden, benefit from DAA treatment.

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