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Buprenorphine and adherence

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https://www.readbyqxmd.com/read/29627621/the-optima-study-buprenorphine-naloxone-and-methadone-models-of-care-for-the-treatment-of-prescription-opioid-use-disorder-study-design-and-rationale
#1
M Eugenia Socias, Keith Ahamad, Bernard Le Foll, Ron Lim, Julie Bruneau, Benedikt Fischer, T Cameron Wild, Evan Wood, Didier Jutras-Aswad
BACKGROUND: Rates of non-medical use of opioids, and opioid use disorders (OUD) have been rising throughout North America. Methadone and buprenorphine/naloxone are the recommended first-line treatment options for OUD in Canada. Most studies to date have been conducted among heroin users, in controlled settings, and using similar strict dosing schedules (i.e., daily witnessed ingestion) despite buprenorphine/naloxone's superior safety profile, which allows a more flexible take-home dosing schedule...
April 5, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29623562/decline-in-buprenorphine-naloxone-prescriptions-in-a-state-medicaid-population-following-formulary-conversion-from-suboxone-to-bunavail
#2
Richard Soper, Sireesh Appajosyula, Christina Deximo
INTRODUCTION: A large, statewide, fee-for-service Medicaid plan recently (October 2015) executed a complete switch from sublingual buprenorphine-naloxone [(SLBN), Suboxone® ] to buccal buprenorphine-naloxone [(BBN), Bunavail® ] on its preferred drug formulary. This complete formulary switch provided an opportunity to assess dynamic changes in prescribing patterns, patient/physician acceptance, and indices of potential misuse/diversion. METHODS: For the period January 1, 2015 through December 31, 2016, two datasets were analyzed: prescriptions and associated costs for buprenorphine-naloxone (BN) products and urine toxicology test results for patients in the Medicaid plan...
April 6, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29579725/addressing-discordant-quantitative-urine-buprenorphine-and-norbuprenorphine-levels-case-examples-in-opioid-use-disorder
#3
Stephen R Holt, Joseph H Donroe, Dana A Cavallo, Jeanette M Tetrault
INTRODUCTION: Urine adulteration is a concern among patients treated for opioid use disorder. Quantitative urine testing for buprenorphine (B) and norbuprenorphine (NB), and the appropriate interpretation of B and NB levels, can facilitate constructive conversations with patients that may lead to modifications in the treatment plan, and strengthening of the patient-provider relationship. CASE SUMMARY: Three cases are presented in which discordant urine B and NB levels were recognized...
May 1, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29573648/atomoxetine-for-amphetamine-type-stimulant-dependence-during-buprenorphine-treatment-a-randomized-controlled-trial
#4
Richard S Schottenfeld, Marek C Chawarski, Mehmet Sofuoglu, Weng-Tink Chooi, Norzarina M Zaharim, M Azhar M Yasin, Imran Ahmad, Sharifah Zubaidiah Syed Jaapar, B Kasinather Vicknasingam
BACKGROUND: Amphetamine type stimulants (ATS) use is highly prevalent and frequently co-occurs with opioid dependence in Malaysia and Asian countries. No medications have established efficacy for treating ATS use disorder. This study evaluated the safety, tolerability, and potential efficacy of atomoxetine for treating ATS use disorder. METHODS: Participants with opioid and ATS dependence (N = 69) were enrolled in a pilot, double-blind, placebo-controlled randomized clinical trial; all received buprenorphine/naloxone and behavioral counseling and were randomized to atomoxetine 80 mg daily (n = 33) or placebo (n = 33)...
March 10, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29529456/rehospitalization-and-substance-use-disorder-sud-treatment-entry-among-patients-seen-by-a-hospital-sud-consultation-liaison-service
#5
Courtney D Nordeck, Christopher Welsh, Robert P Schwartz, Shannon Gwin Mitchell, Art Cohen, Kevin E O'Grady, Jan Gryczynski
BACKGROUND: Substance use disorders (SUD) are associated with non-adherence to medical care and high utilization of hospital services. This study characterized patterns and correlates of rehospitalization among patients seen by a hospital-based SUD consultation-liaison (CL) team. METHODS: This study was a retrospective medical record review of patients in a large urban academic hospital who received SUD consultation and were diagnosed with opioid, cocaine, and/or alcohol use disorder (N = 267)...
March 2, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29509558/transferring-patients-from-methadone-to-buprenorphine-the-feasibility-and-evaluation-of-practice-guidelines
#6
Nicholas Lintzeris, Lauren A Monds, Consuelo Rivas, Stefanie Leung, Adrian Dunlop, David Newcombe, Carina Walters, Susanna Galea, Nancy White, Mark Montebello, Apo Demirkol, Nicola Swanson, Robert Ali
INTRODUCTION AND AIMS: Transfer from methadone to buprenorphine is problematic for many opioid-dependent patients, with limited documented evidence or practical clinical guidance, particularly for the range of methadone doses routinely prescribed for most patients (>50 mg). This study aimed to implement and evaluate recent national Australian guidelines for transferring patients from methadone to buprenorphine. DESIGN AND METHODS: A multisite prospective cohort study...
March 5, 2018: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29450210/sofosbuvir-based-direct-acting-antiviral-therapies-for-hcv-in-people-receiving-opioid-substitution-therapy-an-analysis-of-phase-3-studies
#7
Jason Grebely, Jordan J Feld, David Wyles, Mark Sulkowski, Liyun Ni, Joe Llewellyn, Heshaam M Mir, Nika Sajed, Luisa M Stamm, Robert H Hyland, John McNally, Diana M Brainard, Ira Jacobson, Stefan Zeuzem, Marc Bourlière, Graham Foster, Nezam Afdhal, Gregory J Dore
Background: Hepatitis C virus (HCV) direct-acting antiviral therapy is effective among people receiving opioid substitution therapy (OST), but studies are limited by small numbers of nongenotype 1 (GT1) patients. The aim of this study was to evaluate the treatment completion, adherence, SVR12, and safety of sofosbuvir-based therapies in HCV patients receiving and not receiving OST. Methods: Ten phase 3 studies of sofosbuvir-based regimens included ION (ledipasvir/sofosbuvir ± ribavirin for 8, 12, or 24 weeks in GT1), ASTRAL (sofosbuvir/velpatasvir for 12 weeks in GT1-6), and POLARIS (sofosbuvir/velpatasvir and sofosbuvir/velpatasvir/voxilaprevir in GT1-6)...
February 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29432333/buprenorphine-treatment-for-adolescents-and-young-adults-with-opioid-use-disorders-a-narrative-review
#8
Jacob T Borodovsky, Sharon Levy, Marc Fishman, Lisa A Marsch
: In the past decade, a new cohort of adolescents and young adults with opioid use disorders (OUD) has emerged. While medications and psychosocial treatments are available, few adolescents and young adults with OUD can access and remain in treatment. Effective, practical, and scalable treatment paradigms for this young population are needed. Buprenorphine is a medication with unique pharmacological and regulatory characteristics that make it a promising component of adolescent and young adult OUD treatment models...
February 9, 2018: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29426304/rationale-design-and-methodology-of-a-trial-evaluating-three-models-of-care-for-hcv-treatment-among-injection-drug-users-on-opioid-agonist-therapy
#9
Matthew J Akiyama, Linda Agyemang, Julia H Arnsten, Moonseong Heo, Brianna L Norton, Bruce R Schackman, Benjamin P Linas, Alain H Litwin
BACKGROUND: People who inject drugs (PWID) constitute 60% of the approximately 5 million people in the U.S. infected with hepatitis C virus (HCV). Treatment of PWID is complex due to addiction, mental illness, poverty, homelessness, lack of positive social support, poor adherence-related skills, low motivation and knowledge, and poor access to and trust in the health care system. New direct-acting antiviral medications are available for HCV with high cure rates and few side effects. The life expectancy and economic benefits of new HCV treatments will not be realized unless we determine optimal models of care for the majority of HCV-infected patients...
February 9, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29415846/associations-between-pharmacotherapy-for-opioid-dependence-and-clinical-and-criminal-justice-outcomes-among-adults-with-co-occurring-serious-mental-illness
#10
Allison G Robertson, Michele M Easter, Hsiu-Ju Lin, Linda K Frisman, Jeffrey W Swanson, Marvin S Swartz
Adults suffering from a serious mental illness (SMI) and a substance use disorder are at especially high risk for poor clinical outcomes and also arrest and incarceration. Pharmacotherapies for treating opioid dependence could be a particularly important mode of treatment for opioid-dependent adults with SMI to lower their risk for overdose, high-cost hospitalizations, repeated emergency department visits, and incarceration, given relapse rates are very high following detoxification in the absence of one of the three FDA-approved pharmacotherapies...
March 2018: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29396985/extended-release-injectable-naltrexone-for-opioid-use-disorder-a-systematic-review
#11
REVIEW
Brantley P Jarvis, August F Holtyn, Shrinidhi Subramaniam, D Andrew Tompkins, Emmanuel A Oga, George E Bigelow, Kenneth Silverman
AIMS: To review systematically the published literature on extended-release naltrexone (XR-NTX, Vivitrol®), marketed as a once-per-month injection product to treat opioid use disorder. We addressed the following questions: (1) How successful is induction on XR-NTX?; (2) What are adherence rates to XR-NTX?; and (3) Does XR-NTX decrease opioid use? Factors associated with these outcomes as well as overdose rates were examined. METHODS: We searched PubMed and used Google Scholar for forward citation searches of peer-reviewed articles from January 2006 to June 2017...
February 3, 2018: Addiction
https://www.readbyqxmd.com/read/29320915/healthcare-utilization-and-costs-associated-with-treatment-for-opioid-dependence
#12
Ankit Shah, Margaret Duncan, Nipun Atreja, Kei Sing Tai, Mugdha Gore
OBJECTIVE: Opioid use disorder (OUD) can be managed with medication assisted therapy (MAT) (methadone [MET], buprenorphine [BUP], or extended-release naltrexone [XR-NTX]) or counseling alone (non-pharmacological therapy [NPT]). The objective of this study was to evaluate healthcare resource utilization and costs associated with XR-NTX compared with alternative treatments for opioid dependence. METHODS: Adults with a diagnosis of opioid dependence who initiated treatment with XR-NTX, BUP, MET, or NPT between January 1, 2011 and December 31, 2014 were identified in the Truven Health MarketScan Commercial administrative claims database...
April 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29143483/the-impact-of-mental-health-comorbidities-on-adherence-to-buprenorphine-a-claims-based-analysis
#13
Megan Litz, Douglas Leslie
BACKGROUND AND OBJECTIVES: Previous research has been inconclusive about whether opioid-dependent patients with psychiatric comorbidities have shorter treatment retention and higher relapse rates. This study aims to evaluate the impact of mental health comorbidities on adherence to buprenorphine using a large, national health insurance claims data base. METHODS: We used MarketScan® data from 2012 to 2014 to perform this analysis. Inclusion criteria included all patients with an opioid use disorder-related ICD-9 code who had been prescribed buprenorphine (n = 2947)...
November 16, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/29141650/neuropsychological-function-is-improved-among-opioid-dependent-adults-who-adhere-to-opiate-agonist-treatment-with-buprenorphine-naloxone-a-preliminary-study
#14
Travis M Scott, Monica Rivera Mindt, Chinazo O Cunningham, Franchesca Arias, Kelly Coulehan, Aprille Mangalonzo, Pat Olsen, Julia H Arnsten
BACKGROUND: Among persons with opioid use disorder (OUD), neuropsychological dysfunction is associated with depression, and better neuropsychological function is associated with opioid abstinence. However, it is unknown whether depressive symptomatology or adherence to opiate agonist treatment are associated with neuropsychological change over time. METHODS: We recruited 20 buprenorphine/naloxone-treated adults with OUD (M Age = 45.2 years [SD = 8.1]; 25% female) to complete baseline and 6 month visits containing a neuropsychological test battery and self-reported measures of depressive symptomatology and medication adherence...
November 15, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/29096016/opioid-use-disorders-medication-assisted-treatment-and-the-role-of-the-laboratory
#15
Roger L Bertholf, Gary M Reisfield
Urine drug testing is an essential component in the evaluation and management of individuals with opioid use disorders, including those on buprenorphine or methadone maintenance therapies. Notwithstanding its centrality in adherence monitoring, studies have shown that clinicians have important knowledge deficiencies regarding the ordering and interpretation of drug tests. In this review, we discuss the scope and frequency of testing, the advantages and disadvantages of immunoassay- (presumptive) and liquid chromatograph-mass spectrometry- (definitive) based techniques, indications for definitive testing, medical necessity, and other considerations...
November 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29068826/opioid-addiction-in-pregnancy-does-depression-negatively-impact-adherence-with-prenatal-care
#16
Lauren Hensley, Suela Sulo, Sarah Kozmic, Barbara V Parilla
OBJECTIVE: We aimed to evaluate whether depression in pregnancy in women with opioid dependency negatively impacts adherence with prenatal care. METHODS: This was a retrospective chart analysis of opioid-dependent pregnant women over a 6-year period at 2 large referral and tertiary care centers. The primary outcome was adherence with prenatal care based on the concurrent diagnosis of depression. Adherence was assessed by looking at the number of observed versus expected prenatal visits...
January 2018: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28829626/transitioning-from-methadone-to-buprenorphine-maintenance-in-management-of-opioid-use-disorder-during-pregnancy
#17
Shakevia Johnson, Peter R Martin
BACKGROUND: Opioid use disorder during pregnancy is a growing health concern. Methadone maintenance is the treatment of choice but emerging data indicate buprenorphine is a viable alternative. Due to costs and limited accessibility of methadone, pregnant women may require transition from methadone to buprenorphine for maintenance treatment. OBJECTIVES: To assess safety and effectiveness of transitioning from methadone to buprenorphine when necessary during pregnancy...
2018: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28817294/heterogeneity-of-nonadherent-buprenorphine-patients-subgroup-characteristics-and-outcomes
#18
Charles Ruetsch, Joseph Tkacz, Vijay R Nadipelli, Brenna L Brady, Naoko Ronquest, Hyong Un, Joseph Volpicelli
OBJECTIVES: To examine patient characteristics and outcomes associated with nonadherence to buprenorphine and to identify specific patterns of nonadherent behavior. STUDY DESIGN: Cross-sectional, retrospective analysis of health claims data. METHODS: Aetna's administrative claims data were used to categorize incident opioid use disorder (OUD) patients based on buprenorphine medication possession ratio (MPR) into adherent (n = 172) and nonadherent (n = 305) groups...
June 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28799677/text-message-reminders-for-improving-patient-appointment-adherence-in-an-office-based-buprenorphine-program-a-feasibility-study
#19
Babak Tofighi, Frank Grazioli, Sewit Bereket, Ellie Grossman, Yindalon Aphinyanaphongs, Joshua David Lee
BACKGROUND AND OBJECTIVES: Missed visits are common in office-based buprenorphine treatment (OBOT). The feasibility of text message (TM) appointment reminders among OBOT patients is unknown. METHODS: This 6-month prospective cohort study provided TM reminders to OBOT program patients (N = 93). A feasibility survey was completed following delivery of TM reminders and at 6 months. RESULTS: Respondents reported that the reminders should be provided to all OBOT patients (100%) and helped them to adhere to their scheduled appointment (97%)...
August 11, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28723256/quantitative-testing-of-buprenorphine-and-norbuprenorphine-to-identify-urine-sample-spiking-during-office-based-opioid-treatment
#20
Joji Suzuki, Jennifer Zinser, Mohammed Issa, Claudia Rodriguez
BACKGROUND: Patients may spike urine samples with buprenorphine during office-based opioid treatment to simulate adherence to prescribed buprenorphine, potentially to conceal diversion of medications. However, routine immunoassay screens do not detect instances of spiking, as these would simply result in a positive result. The aim of this study was to report on the experience of using quantitative urine testing for buprenorphine and norbuprenorphine to facilitate the identification of urine spiking...
July 19, 2017: Substance Abuse
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