International Journal of Environmental Research and Public Health 2022; 19(7): 4106. [doi: 10.3390/ijerph19074106]
Bergen, Andrew W. | Baurley, James W. | Ervin, Carolyn M. | McMahan, Christopher S. | Bible, Joe | Stafford, Randall S. | Mudumbai, Seshadri C. | Saxon, Andrew J.
The impact of agonist dose and of physician, staff, and patient engagement on treatment have not been evaluated together in the analysis of treatment for opioid use disorder. The hypothesis for this study was that greater agonist dose and therapeutic engagement would be associated with reduced illicit opiate use in a time-dependent matter. Publicly available treatment data from six buprenorphine efficacy and safety trials from the federally-supported NIDA Clinical Trials Network were used to derive treatment variables. Three novel predictors were constructed to capture the time-weighted effects of buprenorphine dosage (mg buprenorphine per day), dosing protocol (whether physician could adjust dose), and clinic vicits (whether patient attended clinic). Researchers used time-in-trial as a predictor to account for the therapeutic benefits of treatment persistence. The outcome was illicit opiate use defined by self-report or urinalysis. Trial participants (N=3022 patients with opioid dependence, mean age 36 years, 33% female, 14% Black, 16% Hispanic) were analyzed using a generalized linear mixed model. Treatment variables dose, Odds Ratio (OR) = 0.63, dosing protocol, OR = 0.79, time-in-trial, OR = 0.75, and clinic visits, OR = 0.81 were significant protective factors.
Conclusions: Treatment implications support higher doses of buprenorphine and greater engagement of patients with providers and clinic stuff.
Keywords: CTN platform/ancillary study | Buprenorphine | Opioid use disorder | Therapeutic alliance | International Journal of Environmental Research and Public Health (journal)
Document No: 1511 ; PMID: 35409790 ; PMCID: PMC8998781
Submitted by: CTN Dissemination Librarian (4/5/2022)
