Three-year retention in buprenorphine treatment for opioid use disorder nationally in the Veterans Health Administration
Three-year retention in buprenorphine treatment for opioid use disorder nationally in the Veterans Health Administration
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DOI：
10.1111/ajad.12553
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发表时间：
2017-09-01
影响因子：
3.7
通讯作者：
Rosenheck, Robert
中科院分区：
文献类型：
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作者：
Manhapra, Ajay;Petrakis, Ismene;Rosenheck, Robert
背景丁丙诺啡已成为阿片类药物使用障碍（OUD）的主要治疗方法，但关于长期治疗保留及其相关性的数据很少。和在一年的前60天后根据第一次处方开始丁丙诺啡治疗的患者，2012-2015财年的最后一次处方退伍军人根据从第一次到最后一次处方的时间分为四组：（0-30天，31-365天; 1-3年; 3年以上）。这些群体进行了比较的社会人口，诊断和服务，精神药物的使用。Kaplan-Meier曲线和考克斯比例风险模型用于确定与丁丙诺啡治疗中保留相关的独立变量。结果新开始丁丙诺啡治疗的退伍军人（n= 3，151）平均保留治疗时间为1.68年（标准差[SD] 1.23），其中61.60%（n= 1，941）保留超过1年，31.83%（n= 1，003）保留超过3年。考克斯比例风险模型显示，2012财年，仅黑人（风险比[HR] 1.26;标准误[SE] .06; p.0003）、Charlson指数（HR 1.03; SE .01; p.0132）和急诊室就诊（HR 1.03; SE .01; p
BackgroundBuprenorphine has become the major treatment for opioid use disorder (OUD) but data on long treatment term retention and its correlates are sparse.MethodsAll veterans with OUD treated in Veterans Health Administration (VHA) facilities nationally in fiscal year (FY) 2012, and who began treatment with buprenorphine as indicated by a first prescription after the first 60 days of the year were identified with the date of and their last prescription from FY 2012-2015. Veterans were classified into four groups based on time from first to last prescription: (0-30 days, 31-365 days; 1-3 years; and more than 3 years). These groups were compared on socio-demographic, diagnoses and service, and psychotropic drug use. Kaplan-Meier curves and Cox proportional hazards models were used to identify variables independently associated with retention in buprenorphine treatment.ResultsVeterans newly started on buprenorphine (n=3,151) were retained in treatment for a mean duration of 1.68 years (standard deviation [SD] 1.23), with 61.60% (n=1,941) retained for more than a year and 31.83% (n=1,003) for more than 3 years. Cox proportion hazards model showed that only black race (Hazards ratio [HR] 1.26; standard error [SE] .06; p.0003), the Charlson index (HR 1.03; SE .01; p.0132) and emergency room visits during FY 2012 (HR 1.03; SE .01; p