Evaluation of Functional Status Among Patients Undergoing Maintenance Treatments for Opioid use Disorders

2020 ◽  
Author(s):  
Juan Jesús Ruíz Ruíz ◽  
José María Martínez Delgado ◽  
Nuria García ◽  
Bartolomé Baena
Keyword(s):  
Sexual Dysfunction ◽  
Opioid Dependence ◽  
Functional Disability ◽  
Methadone Treatment ◽  
Sexual Problems ◽  
Opioid Use ◽  
Whodas 2.0 ◽  
Maintenance Program ◽  
Methadone Group ◽  
Buprenorphine Treatment

Abstract Objective Methadone and buprenorphine are the most prevalent types of opioid maintenance programs in Andalusia. The main objective is comparing the functional and health status of patients with pharmacological opioid maintenance treatments according to different socio-demographic characteristic, disabilities and sexual functioning difficulties. Methods A total of 593 patients from the Andalusia community, 329 were undergoing methadone treatment and 264 were undergoing buprenorphine treatment. The patients were interviewed by socio-demographic and opioid-related variables, assessed by functional disability and health variables ( WHODAS 2.0. ) and for sexual dysfunction ( PRSexDQ-SALSEX ). Results We found significant differences in the socio-demographic and the opioid-related variables as the onset of opioid use, being on previous maintenance programs, opioid intravenous use, the length of previous maintenance programs, polydrug use and elevated seroprevalence rates (HCV and HIV) between the methadone group and the buprenorphine group. There were differences in the Understanding and communication domain, Getting around domain, Participation in society domain and in the WHODAS 2.0. simple and complex score, favoring buprenorphine-treated patients. The methadone group had elevated sexual dysfunction than the buprenorphine group. Opioid-related variables as seroprevalence rates, other previous lifetime maintenance program, the daily opioid dosage and the daily alcohol use are the most discriminative variables between both groups. Participation in society variables and sexual problems were the most important clinical variables in distinguishing the methadone group from the buprenorphine group. Conclusions The methadone group showed higher prevalence in opioid dependence-related variables, elevated disabilities in participation in society activities and sexual problems compared with the buprenorphine group.

scholarly journals Evaluation of functional status among patients undergoing maintenance treatments for opioid use disorders

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Juan J. Ruíz Ruíz ◽  
◽  
José M. Martinez Delgado ◽  
Nuria García-Marchena
Keyword(s):  
Functional Status ◽  
Methadone Treatment ◽  
Social Activity ◽  
Sexual Problems ◽  
Functional Evaluation ◽  
Opioid Use ◽  
Whodas 2.0 ◽  
Maintenance Program ◽  
Methadone Group ◽  
Health Domains

Abstract Background Methadone and buprenorphine are the most prevalent types of opioid maintenance programs in Andalusia. The main objective is comparing the functional status of patients with pharmacological opioid maintenance treatments according to different socio-demographic characteristic, health and disabilities domains and sexual difficulties. Methods A total of 593 patients from the Andalusia community, 329 were undergoing methadone treatment and 264 were undergoing buprenorphine treatment. The patients were interviewed by socio-demographic and opioid-related variables, assessed by functioning, disability and health domains (WHODAS 2.0.) and for sexual problems (PRSexDQ-SALSEX). Results We found significant differences in the socio-demographic and the opioid-related variables as the onset of opioid use, being on previous maintenance programs, opioid intravenous use, the length of previous maintenance programs, polydrug use and elevated seroprevalence rates (HCV and HIV) between the methadone group and the buprenorphine group. Regarding health and disability domains there were differences in the Understanding and communication domain, Getting around domain, Participation in society domain and in the WHODAS 2.0. simple and complex score, favoring buprenorphine-treated patients. The methadone group referred elevated sexual impairments compared with the buprenorphine group. Opioid-related variables as seroprevalence rates, other previous lifetime maintenance program, the daily opioid dosage and the daily alcohol use are the most discriminative variables between both groups. Participation in society variables and sexual problems were the most important clinical variables in distinguishing the methadone group from the buprenorphine group regarding their functional status. Conclusions The methadone group showed higher prevalence in opioid dependence-related variables, elevated disabilities in participation in society activities and sexual problems compared with the buprenorphine group. This study shows the importance of carry out a functional evaluation in the healthcare follow-up, especially in those areas related with social activity and with sexual problems.

scholarly journals Buprenorphine treatment of opioid dependence: analysis of individual patient data

2020 ◽  
Author(s):  
Andrew W Bergen ◽  
James W Baurley ◽  
Carolyn M Ervin ◽  
Christopher S McMahan ◽  
Joe Bible ◽  
...  
Keyword(s):  
Opioid Dependence ◽  
Mixed Model ◽  
Randomized Clinical Trials ◽  
Linear Mixed Model ◽  
Treatment Success ◽  
List Type ◽  
Efficacy And Safety ◽  
Opioid Use ◽  
Lapse Time ◽  
Buprenorphine Treatment

AbstractBackgroundThe efficacy and safety of buprenorphine alone and in combination with naloxone for treatment of opioid dependence were evaluated in Federally-sponsored randomized clinical trials. Meta-analysis of pooled individual participant data provides an opportunity to identify multiple predictors of buprenorphine treatment outcome.MethodsWe selected six buprenorphine efficacy and safety trials from NIDA’s Data Share database for analysis. Treatment, sociodemographic, and drug use history variable domains were systematically harmonized and included in analysis. After exclusions, 3,022 participants randomized or enrolled in buprenorphine treatment for opioid dependence (mean (SD) age 36.1 (9.8) years, 33% female, 66% White, 16% Hispanic, 14% Black), were analyzed using a generalized linear mixed model with time-weighted treatment variables and participant covariates. We defined positive urinalysis or self-reported lapse as the primary outcome.ResultsFour treatment variables were significantly associated (p < 0.001) with lapse. Time-weighted dose and time-weighted adaptive dose had greater estimated effects than time-in-trial and time-weighted clinic visit. All treatment variables were novel predictors of lapse.ConclusionsIn a large cohort of trial participants treated with buprenorphine and behavioral counseling for opioid dependence, we identified and ranked four novel treatment factors reflecting components of buprenorphine dose, clinical provider engagement and patient engagement. Additional research to explore the effects of pharmacologic and non- pharmacologic treatment factors, and to explore relations with provider and patient factors will help our understanding of buprenorphine treatment outcomes. Continued analyses of publicly available data will extend discovery and support development of personalized opioid use disorder treatments.Highlights (3 to 5 bullet point max 85 characters each including spaces)Treatment and participant variables were harmonized in six buprenorphine trialsTime-weighted treatment variables were used in a random effects mixed model of lapseBuprenorphine dose and three clinical interactions were protective against lapseSupport of protective treatment factors may improve buprenorphine treatment success

Determinants of Buprenorphine Treatment for Opioid Dependence

2013 ◽  
Author(s):  
Sean M. Murphy ◽  
Paul A. Fishman ◽  
Sterling M. McPherson ◽  
Dennis G. Dyck ◽  
John M. Roll
Keyword(s):  
Opioid Dependence ◽  
Buprenorphine Treatment

Impact of High Deductible Health Plans on Continuous Buprenorphine Treatment for Opioid Use Disorder

2021 ◽  
Author(s):  
Alene Kennedy-Hendricks ◽  
Cameron J. Schilling ◽  
Alisa B. Busch ◽  
Elizabeth A. Stuart ◽  
Haiden A. Huskamp ◽  
...  
Keyword(s):  
Opioid Use Disorder ◽  
Health Plans ◽  
Opioid Use ◽  
Buprenorphine Treatment

Buprenorphine treatment of opioid dependence: clinical trial of daily versus alternate-day dosing

1995 ◽  
Vol 40 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Rolley E. Johnson ◽  
Thomas Eissenberg ◽  
Maxine L. Stitzer ◽  
Eric C. Strain ◽  
Ira A. Liebson ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Opioid Dependence ◽  
Buprenorphine Treatment

scholarly journals Project ECHO and primary care buprenorphine treatment for opioid use disorder: Implementation and clinical outcomes

2021 ◽  
pp. 1-9
Author(s):  
James B. Anderson ◽  
Stephen A. Martin ◽  
Anne Gadomski ◽  
Nicole Krupa ◽  
Daniel Mullin ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Outcomes ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Project Echo ◽  
Buprenorphine Treatment

scholarly journals Combating escalating harms associated with pharmaceutical opioid use in Australia: the POPPY II study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e025840 ◽  
Author(s):  
Natasa Gisev ◽  
Sallie-Anne Pearson ◽  
Timothy Dobbins ◽  
David C Currow ◽  
Fiona Blyth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Opioid Dependence ◽  
Service Use ◽  
Population Level ◽  
Ethics Committee ◽  
Adverse Outcomes ◽  
Opioid Use ◽  
Research Committee ◽  
Services Research ◽  
Wide Range

IntroductionOpioid prescribing has increased 15-fold in Australia in the past two decades, alongside increases in a range of opioid-related harms such as opioid dependence and overdose. However, despite concerns about increasing opioid use, extramedical use and harms, there is a lack of population-level evidence about the drivers of long-term prescribed opioid use, dependence, overdose and other harms.Methods and analysisWe will form a cohort of all adult residents in New South Wales (NSW), Australia, who initiated prescribed opioids from 2002 using Pharmaceutical Benefits Scheme dispensing records. This cohort will be linked to a wide range of other datasets containing information on sociodemographic and clinical characteristics, health service use and adverse outcomes (eg, opioid dependence and non-fatal and fatal overdose). Analyses will initially examine patterns and predictors of prescribed opioid use and then apply regression and survival analysis to quantify the risks and risk factors of adverse outcomes associated with prescribed opioid use.Ethics and disseminationThis study has received full ethical approval from the Australian Institute of Health and Welfare Ethics Committee, the NSW Population and Health Services Research Committee and the ACT Health Human Research Ethics Committee. This will be the largest postmarketing surveillance study of prescribed opioids undertaken in Australia, linking exposure and outcomes and examining risk factors for adverse outcomes of prescribed opioids. As such, this work has important translational promise, with direct relevance to regulatory authorities and agencies worldwide. Project findings will be disseminated at scientific conferences and in peer-reviewed journals. We will also conduct targeted dissemination with policy makers, professional bodies and peak bodies in the pain, medicine and addiction fields through stakeholder workshops and advisory groups. Results will be reported in accordance with the REporting of studies Conducted using Observational Routinely collected Data (RECORD) Statement.

scholarly journals Buprenorphine Induction in a Rural Maryland Detention Center During COVID-19: Implementation and Preliminary Outcomes of a Novel Telemedicine Treatment Program for Incarcerated Individuals With Opioid Use Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Annabelle M. Belcher ◽  
Kelly Coble ◽  
Thomas O. Cole ◽  
Christopher J. Welsh ◽  
Anna Whitney ◽  
...  
Keyword(s):  
Opioid Use Disorder ◽  
Community Treatment ◽  
Successful Implementation ◽  
Opioid Use ◽  
Screening Process ◽  
Detention Center ◽  
Medication Prescription ◽  
Proven Efficacy ◽  
Pass Through ◽  
Buprenorphine Treatment

Over 10 million individuals pass through U.S. detention centers on an annual basis, with nearly two-thirds meeting criteria for drug dependence/abuse. Despite proven efficacy, treatment with medications for opioid use disorder (MOUD) is underutilized in jail settings—a gap that could be addressed using telemedicine. Here we describe a new program of telemedicine-based clinical provision of new/continuing buprenorphine treatment for individuals detained in a rural jail. Implementation objectives were completed between January and August 2020, and patient encounters were conducted between August 2020 and February 2021. We established (i) telemedicine hardware/software capability; (ii) a screening process; (iii) buprenorphine administration methods; (iv) necessary medical release procedures; (v) telemedicine encounter coordination and medication prescription procedures; and (vi) a research platform. Seven incarcerated patients have been treated, two of whom were referred from community treatment. Patients were mostly male (71%), non-Hispanic White (86%), and averaged 33 years old. All patients tested positive for an opioid upon intake and began/continued buprenorphine treatment in the jail. Average time to first MOUD appointment was 9 days and patients were maintained in treatment an average 21 days. Referrals for continuing community treatment were offered to all patients prior to discharge. We report successful implementation of telemedicine MOUD in a rural detention center, with treatment engagement and initiation occurring prior to the high-risk period of discharge. The fact that this program was launched during the height of the pandemic highlights the flexibility of telemedicine-based buprenorphine treatment. Challenges and obstacles to implementation of buprenorphine treatment in a correctional system are discussed.

Sign in / Sign up

Export Citation Format

Share Document