Buprenorphine use and courses of care for opioid use disorder treatment within the Veterans Health Administration. Gordon, A. J., Saxon, A. J., Kertesz, S., Wyse, J. J., Manhapra, A., Lin, L. A., Chen, W., Hansen, J., Pinnell, D., Huynh, T., Baylis, J. D., Cunningham, F. E., Ghitza, U. E., Bart, G., Yu, H., & Sauer, B. C. Drug and Alcohol Dependence, 248:109902, July, 2023. ![Buprenorphine use and courses of care for opioid use disorder treatment within the Veterans Health Administration [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Background Retention of patients in buprenorphine medication treatment for opioid use disorder (B-MOUD) reduces harms associated with opioid use disorder (OUD). We sought to characterize the patients receiving B-MOUD and courses of B-MOUD in a large healthcare system. Methods We conducted a retrospective, open cohort study of patients with OUD who either did or did not receive B-MOUD courses within the Veterans Health Administration (VHA) from January 2006 through July 2019, using VHA clinical data. We compared patients receiving or not receiving B-MOUD, characterized B-MOUD courses (e.g., length and doses), and examined persistence, across patient characteristics, over time. We used analyses for normally or non-normally distributed continuous variables, categorical data, and persistence over time (Kaplan-Meier persistence curves). Results We identified 255,726 Veterans with OUD; 40,431 (15.8%) had received 63,929 B-MOUD courses. Compared to patients with OUD without B-MOUD, patients with B-MOUD were younger, more often of white race, and had more co-morbidities. The frequency of new B-MOUD starts and prevalent B-MOUD patients ranged from 1550 and 1989 in 2007 to 8146 and 16,505 in 2018, respectively. The median duration of B-MOUD was 157 (IQR: 37–537) days for all courses and 33.8% patients had more than one course. The average proportion days covered was 90% (SD: 0.15), and the average prescribed daily dose was 13.44 (SD: 6.5). Conclusions Within a VHA B-MOUD cohort, courses increased more than 10-fold from 2006 to 2016 with nearly half of patients experiencing multiple courses. Patient demographics seem to dictate the length of courses.
@article{gordon_buprenorphine_2023,
title = {Buprenorphine use and courses of care for opioid use disorder treatment within the {Veterans} {Health} {Administration}},
volume = {248},
issn = {0376-8716},
url = {https://www.sciencedirect.com/science/article/pii/S0376871623001400},
doi = {10.1016/j.drugalcdep.2023.109902},
abstract = {Background
Retention of patients in buprenorphine medication treatment for opioid use disorder (B-MOUD) reduces harms associated with opioid use disorder (OUD). We sought to characterize the patients receiving B-MOUD and courses of B-MOUD in a large healthcare system.
Methods
We conducted a retrospective, open cohort study of patients with OUD who either did or did not receive B-MOUD courses within the Veterans Health Administration (VHA) from January 2006 through July 2019, using VHA clinical data. We compared patients receiving or not receiving B-MOUD, characterized B-MOUD courses (e.g., length and doses), and examined persistence, across patient characteristics, over time. We used analyses for normally or non-normally distributed continuous variables, categorical data, and persistence over time (Kaplan-Meier persistence curves).
Results
We identified 255,726 Veterans with OUD; 40,431 (15.8\%) had received 63,929 B-MOUD courses. Compared to patients with OUD without B-MOUD, patients with B-MOUD were younger, more often of white race, and had more co-morbidities. The frequency of new B-MOUD starts and prevalent B-MOUD patients ranged from 1550 and 1989 in 2007 to 8146 and 16,505 in 2018, respectively. The median duration of B-MOUD was 157 (IQR: 37–537) days for all courses and 33.8\% patients had more than one course. The average proportion days covered was 90\% (SD: 0.15), and the average prescribed daily dose was 13.44 (SD: 6.5).
Conclusions
Within a VHA B-MOUD cohort, courses increased more than 10-fold from 2006 to 2016 with nearly half of patients experiencing multiple courses. Patient demographics seem to dictate the length of courses.},
language = {en},
urldate = {2023-05-15},
journal = {Drug and Alcohol Dependence},
author = {Gordon, Adam J. and Saxon, Andrew J. and Kertesz, Stefan and Wyse, Jessica J. and Manhapra, Ajay and Lin, Lewei A. and Chen, Wei and Hansen, Jared and Pinnell, Derek and Huynh, Tina and Baylis, Jacob D. and Cunningham, Francesca E. and Ghitza, Udi E. and Bart, Gavin and Yu, Hong and Sauer, Brian C.},
month = jul,
year = {2023},
keywords = {Buprenorphine, Opioid-Related Disorders},
pages = {109902},
}
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{"_id":"De3eDwa55M5bQ6zpB","bibbaseid":"gordon-saxon-kertesz-wyse-manhapra-lin-chen-hansen-etal-buprenorphineuseandcoursesofcareforopioidusedisordertreatmentwithintheveteranshealthadministration-2023","author_short":["Gordon, A. J.","Saxon, A. J.","Kertesz, S.","Wyse, J. J.","Manhapra, A.","Lin, L. A.","Chen, W.","Hansen, J.","Pinnell, D.","Huynh, T.","Baylis, J. D.","Cunningham, F. E.","Ghitza, U. E.","Bart, G.","Yu, H.","Sauer, B. C."],"bibdata":{"bibtype":"article","type":"article","title":"Buprenorphine use and courses of care for opioid use disorder treatment within the Veterans Health Administration","volume":"248","issn":"0376-8716","url":"https://www.sciencedirect.com/science/article/pii/S0376871623001400","doi":"10.1016/j.drugalcdep.2023.109902","abstract":"Background Retention of patients in buprenorphine medication treatment for opioid use disorder (B-MOUD) reduces harms associated with opioid use disorder (OUD). We sought to characterize the patients receiving B-MOUD and courses of B-MOUD in a large healthcare system. Methods We conducted a retrospective, open cohort study of patients with OUD who either did or did not receive B-MOUD courses within the Veterans Health Administration (VHA) from January 2006 through July 2019, using VHA clinical data. We compared patients receiving or not receiving B-MOUD, characterized B-MOUD courses (e.g., length and doses), and examined persistence, across patient characteristics, over time. We used analyses for normally or non-normally distributed continuous variables, categorical data, and persistence over time (Kaplan-Meier persistence curves). Results We identified 255,726 Veterans with OUD; 40,431 (15.8%) had received 63,929 B-MOUD courses. Compared to patients with OUD without B-MOUD, patients with B-MOUD were younger, more often of white race, and had more co-morbidities. The frequency of new B-MOUD starts and prevalent B-MOUD patients ranged from 1550 and 1989 in 2007 to 8146 and 16,505 in 2018, respectively. The median duration of B-MOUD was 157 (IQR: 37–537) days for all courses and 33.8% patients had more than one course. The average proportion days covered was 90% (SD: 0.15), and the average prescribed daily dose was 13.44 (SD: 6.5). Conclusions Within a VHA B-MOUD cohort, courses increased more than 10-fold from 2006 to 2016 with nearly half of patients experiencing multiple courses. Patient demographics seem to dictate the length of courses.","language":"en","urldate":"2023-05-15","journal":"Drug and Alcohol Dependence","author":[{"propositions":[],"lastnames":["Gordon"],"firstnames":["Adam","J."],"suffixes":[]},{"propositions":[],"lastnames":["Saxon"],"firstnames":["Andrew","J."],"suffixes":[]},{"propositions":[],"lastnames":["Kertesz"],"firstnames":["Stefan"],"suffixes":[]},{"propositions":[],"lastnames":["Wyse"],"firstnames":["Jessica","J."],"suffixes":[]},{"propositions":[],"lastnames":["Manhapra"],"firstnames":["Ajay"],"suffixes":[]},{"propositions":[],"lastnames":["Lin"],"firstnames":["Lewei","A."],"suffixes":[]},{"propositions":[],"lastnames":["Chen"],"firstnames":["Wei"],"suffixes":[]},{"propositions":[],"lastnames":["Hansen"],"firstnames":["Jared"],"suffixes":[]},{"propositions":[],"lastnames":["Pinnell"],"firstnames":["Derek"],"suffixes":[]},{"propositions":[],"lastnames":["Huynh"],"firstnames":["Tina"],"suffixes":[]},{"propositions":[],"lastnames":["Baylis"],"firstnames":["Jacob","D."],"suffixes":[]},{"propositions":[],"lastnames":["Cunningham"],"firstnames":["Francesca","E."],"suffixes":[]},{"propositions":[],"lastnames":["Ghitza"],"firstnames":["Udi","E."],"suffixes":[]},{"propositions":[],"lastnames":["Bart"],"firstnames":["Gavin"],"suffixes":[]},{"propositions":[],"lastnames":["Yu"],"firstnames":["Hong"],"suffixes":[]},{"propositions":[],"lastnames":["Sauer"],"firstnames":["Brian","C."],"suffixes":[]}],"month":"July","year":"2023","keywords":"Buprenorphine, Opioid-Related Disorders","pages":"109902","bibtex":"@article{gordon_buprenorphine_2023,\n\ttitle = {Buprenorphine use and courses of care for opioid use disorder treatment within the {Veterans} {Health} {Administration}},\n\tvolume = {248},\n\tissn = {0376-8716},\n\turl = {https://www.sciencedirect.com/science/article/pii/S0376871623001400},\n\tdoi = {10.1016/j.drugalcdep.2023.109902},\n\tabstract = {Background\nRetention of patients in buprenorphine medication treatment for opioid use disorder (B-MOUD) reduces harms associated with opioid use disorder (OUD). We sought to characterize the patients receiving B-MOUD and courses of B-MOUD in a large healthcare system.\nMethods\nWe conducted a retrospective, open cohort study of patients with OUD who either did or did not receive B-MOUD courses within the Veterans Health Administration (VHA) from January 2006 through July 2019, using VHA clinical data. We compared patients receiving or not receiving B-MOUD, characterized B-MOUD courses (e.g., length and doses), and examined persistence, across patient characteristics, over time. We used analyses for normally or non-normally distributed continuous variables, categorical data, and persistence over time (Kaplan-Meier persistence curves).\nResults\nWe identified 255,726 Veterans with OUD; 40,431 (15.8\\%) had received 63,929 B-MOUD courses. Compared to patients with OUD without B-MOUD, patients with B-MOUD were younger, more often of white race, and had more co-morbidities. The frequency of new B-MOUD starts and prevalent B-MOUD patients ranged from 1550 and 1989 in 2007 to 8146 and 16,505 in 2018, respectively. The median duration of B-MOUD was 157 (IQR: 37–537) days for all courses and 33.8\\% patients had more than one course. The average proportion days covered was 90\\% (SD: 0.15), and the average prescribed daily dose was 13.44 (SD: 6.5).\nConclusions\nWithin a VHA B-MOUD cohort, courses increased more than 10-fold from 2006 to 2016 with nearly half of patients experiencing multiple courses. Patient demographics seem to dictate the length of courses.},\n\tlanguage = {en},\n\turldate = {2023-05-15},\n\tjournal = {Drug and Alcohol Dependence},\n\tauthor = {Gordon, Adam J. and Saxon, Andrew J. and Kertesz, Stefan and Wyse, Jessica J. and Manhapra, Ajay and Lin, Lewei A. and Chen, Wei and Hansen, Jared and Pinnell, Derek and Huynh, Tina and Baylis, Jacob D. and Cunningham, Francesca E. and Ghitza, Udi E. and Bart, Gavin and Yu, Hong and Sauer, Brian C.},\n\tmonth = jul,\n\tyear = {2023},\n\tkeywords = {Buprenorphine, Opioid-Related Disorders},\n\tpages = {109902},\n}\n\n","author_short":["Gordon, A. J.","Saxon, A. J.","Kertesz, S.","Wyse, J. J.","Manhapra, A.","Lin, L. A.","Chen, W.","Hansen, J.","Pinnell, D.","Huynh, T.","Baylis, J. D.","Cunningham, F. E.","Ghitza, U. E.","Bart, G.","Yu, H.","Sauer, B. C."],"key":"gordon_buprenorphine_2023","id":"gordon_buprenorphine_2023","bibbaseid":"gordon-saxon-kertesz-wyse-manhapra-lin-chen-hansen-etal-buprenorphineuseandcoursesofcareforopioidusedisordertreatmentwithintheveteranshealthadministration-2023","role":"author","urls":{"Paper":"https://www.sciencedirect.com/science/article/pii/S0376871623001400"},"keyword":["Buprenorphine","Opioid-Related Disorders"],"metadata":{"authorlinks":{}},"html":""},"bibtype":"article","biburl":"http://fenway.cs.uml.edu/papers/pubs-all.bib","dataSources":["TqaA9miSB65nRfS5H"],"keywords":["buprenorphine","opioid-related disorders"],"search_terms":["buprenorphine","use","courses","care","opioid","use","disorder","treatment","within","veterans","health","administration","gordon","saxon","kertesz","wyse","manhapra","lin","chen","hansen","pinnell","huynh","baylis","cunningham","ghitza","bart","yu","sauer"],"title":"Buprenorphine use and courses of care for opioid use disorder treatment within the Veterans Health Administration","year":2023}