Implementation of buprenorphine in the Veterans Health administration: Results of the first 3 years
Implementation of buprenorphine in the Veterans Health administration: Results of the first 3 years
复制标题
DOI：
10.1016/j.drugalcdep.2007.03.010
复制
发表时间：
2007-10-08
影响因子：
4.2
通讯作者：
Liberto, Joseph
中科院分区：
文献类型：
--
作者：
Gordon, Adam J.;Trafton, Jodie A.;Liberto, Joseph
背景：与非退伍军人相比，退伍军人不成比例地被诊断为阿片类药物依赖。舌下丁丙诺啡提供了更多的阿片类激动剂治疗。为了了解这种创新治疗在大型医疗保健系统中的扩散，我们描述了丁丙诺啡在退伍军人健康管理局（VHA）批准作为VHA非处方药的前3年内的引入。方法：使用VHA药房数据库，我们调查了开丁丙诺啡处方的医生数量和接受办公室的退伍军人数量，从2003财政年度到2005财政年度，VHA退伍军人综合服务网络（VISN）内的丁丙诺啡（2002年10月至2005年9月）。从2003财政年度到2005财政年度，阿片类药物依赖的退伍军人人数从25，031人增加到26，859人（>7.3%），规定办公室丁丙诺啡的退伍军人人数从53人增加到739人。在此期间，21名VISN中有16名处方了丁丙诺啡。在2005财政年度，两个VISN占丁丙诺啡处方的31%。丁丙诺啡处方的数量在VISN中变化很大，但从2003财政年度到2005财政年度从212增加到7076。在此期间，每例患者的处方从4.0增加到9.6，处方丁丙诺啡的医生从14增加到170。病人开丁丙诺啡的供应商开丁丙诺啡的比例从3.8增加到4.3，平均增加15.1-41.6处方每个provider.Conclusions：VHA增加，但不均匀，非处方使用办公室为基础的丁丙诺啡在前3年的可用性。出版社：Elsevier爱尔兰Ltd.
Background: Compared to non-veterans, veterans are disproportionately diagnosed with opioid dependence. Sublingual buprenorphine provides greater access to opioid agonist therapy. To understand the diffusion of this innovative treatment within a large healthcare system, we describe the introduction of buprenorphine, within the Veterans Health Administration (VHA) during the first 3 years of its approval as a VHA non-formulary medication.Methods: Using VHA pharmacy databases, we examined the number of physicians who have prescribed buprenorphine and the number of veterans who have received office-based buprenorphine within VHA veterans integrated service networks (VISN) from fiscal years (FY) 2003 through FY 2005 (October 2002 through September 2005).Results: From FY2003 through FY2005 the number of veterans with opioid dependence increased from 25,031 to 26,859 (>7.3%) and the number of veterans prescribed office-based buprenorphine increased from 53 to 739. During this interval, 16 of 21 VISNs had prescribed buprenorphine. In FY2005, two VISNs accounted for 31% of buprenorphine prescriptions. The number of buprenorphine prescriptions varied widely by VISN, but increased from 212 to 7076 from FY2003 through FY2005. During this interval, prescriptions per patient increased from 4.0 to 9.6 and physicians prescribing buprenorphine increased from 14 to 170. The ratio of patients prescribed buprenorphine to providers prescribing buprenorphine increased from 3.8 to 4.3 with an average increase of 15.1-41.6 of prescriptions per provider.Conclusions: VHA increased, but not uniformly, the non-formulary use of office-based buprenorphine during the first 3 years of availability. Published by Elsevier Ireland Ltd.