Characteristics, treatment patterns and retention with extended-release subcutaneous buprenorphine for opioid use disorder: A population-based cohort study in Ontario, Canada

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dc.contributor.authorIacono, Anita
dc.contributor.authorWang, Tianru
dc.contributor.authorTadrous, Mina
dc.contributor.authorCampbell, Tonya
dc.contributor.authorKolla, Gillian
dc.contributor.authorLeece, Pamela
dc.contributor.authorSproule, Beth
dc.contributor.authorKleinman, Robert A.
dc.contributor.authorBesharah, Jes
dc.contributor.authorMunro, Charlotte
dc.contributor.authorDoolittle, McCaffrey
dc.contributor.authorGomes, Tara
dc.date.accessioned2024-02-09T23:19:28Z
dc.date.available2024-02-09T23:19:28Z
dc.date.copyright2023en_US
dc.date.issued2023
dc.descriptionParts of this material are based on data and information compiled and provided by the Ontario Ministry of Health and Canadian Institute for Health Information (CIHI). The analyses, conclusions, opinions and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. This document used data adapted from the Statistics Canada Postal CodeOM Conversion File, which is based on data licensed from Canada Post Corporation, and/or data adapted from the Ontario Ministry of Health Postal Code Conversion File, which contains data copied under license from ©Canada Post Corporation and Statistics Canada. We thank IQVIA Solutions Canada Inc. for use of their Drug Information File. This study and its data are drawn from the traditional territory and home of many diverse Indigenous people from across Ontario.en_US
dc.description.abstractBackground: Uptake and retention for opioid agonist treatment (OAT) remains low. Novel extended-release formulations may improve OAT accessibility by reducing the frequency of healthcare visits. Our aim was to examine uptake, characteristics, treatment patterns and retention of individuals initiating extended-release subcutaneous buprenorphine (BUP-ER), a monthly injectable OAT. Methods: We conducted a population-based cohort study among adults aged 18+ initiated on BUP-ER between February 3, 2020 and March 31, 2022 in Ontario, Canada. Using administrative health data, we defined continuous BUP-ER use based on repeat injections within a 56-day period and used Kaplan-Meier curves to estimate time on treatment. Among new BUP-ER recipients, we described individual and prescriber characteristics, healthcare utilization and treatment patterns. Results: 2366 individuals initiated BUP-ER. The median time to BUP-ER discontinuation was 183 days (interquartile range: 66–428 days) and 52.0% of individuals were co-prescribed buprenorphine/naloxone at least once throughout the period of BUP-ER receipt. Among individuals who initiated on a dose of 300mg BUP-ER and had three or more injections, 18.8% continued to receive only 300mg doses (N=276 of 1470). Furthermore, 28.6% of those whose dose was reduced to 100mg (N=341 of 1194) had a subsequent dose increase to 300mg. Conclusions: On average, people initiating BUP-ER discontinue within the first 6 months of treatment. While BUP-ER is likely providing an important OAT option, the high occurrence of discontinuation, supplementation with buprenorphine/naloxone, and frequent dose increases suggest inadequacy of current dosing recommendations among a proportion of individuals.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipThis study is funded by grants from the Ontario Ministry of Health (Grant #0691) and the Canadian Institutes of Health Research (Grants #153070 and #178163). Funding for this study is also provided by Ontario SPOR Support Unit, which is supported by the Canadian Institutes of Health Research, the Province of Ontario and partner Ontario hospital foundations and institutes. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care (MLTC).en_US
dc.identifier.citationIacono, A., Wang, T., Tadrous, M., Campbell, T., Kolla, G., Leece, P., ... Gomes, T. (2023). Characteristics, treatment patterns and retention with extended-release subcutaneous buprenorphine for opioid use disorder: A population-based cohort study in Ontario, Canada. Drug and Alcohol Dependence, 254, 111032. https://doi.org/10.1016/j.drugalcdep.2023.111032en_US
dc.identifier.urihttps://doi.org/10.1016/j.drugalcdep.2023.111032
dc.identifier.urihttp://hdl.handle.net/1828/15988
dc.language.isoenen_US
dc.publisherDrug and Alcohol Dependenceen_US
dc.subjectopioid use disorderen_US
dc.subjectbuprenorphineen_US
dc.subjectopioid agonist treatmenten_US
dc.subjectdrug discontinuationen_US
dc.subjectpersistenceen_US
dc.subjecthealth services researchen_US
dc.titleCharacteristics, treatment patterns and retention with extended-release subcutaneous buprenorphine for opioid use disorder: A population-based cohort study in Ontario, Canadaen_US
dc.typeArticleen_US

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