Document Detail


Integrating buprenorphine maintenance therapy into federally qualified health centers: real-world substance abuse treatment outcomes.
MedLine Citation:
PMID:  23332439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Few studies have examined real-world effectiveness of integrated buprenorphine maintenance treatment (BMT) programs in federally qualified health centers (FQHCs).
METHODS: Opioid dependent patients (N=266) inducted on buprenorphine between July 2007 and December 2008 were retrospectively assessed at Connecticut's largest FQHC network. Six-month BMT retention and opioid-free time were collected longitudinally from electronic health records; 136 (51.1%) of patients were followed for at least 12 months.
RESULTS: Participants had a mean age of 40.1 years, were primarily male (69.2%) and treated by family practitioners (70.3%). Co-morbidity included HCV infection (59.8%), mood disorders (71.8%) and concomitant cocaine use (59%). Retention on BMT was 56.8% at 6 months and 61.6% at 12 months for the subset observed over 1 year. Not being retained on BMT at 12 months was associated with cocaine use (AOR=2.18; 95% CI=1.35-3.50) while prescription of psychiatric medication (AOR=0.36; 95% CI 0.20-0.62) and receiving on-site substance abuse counseling (AOR=0.34; 95% CI 0.19, 0.59) improved retention. Two thirds of the participants experienced at least one BMT gap of 2 or more weeks with a mean gap length of 116.4 days.
CONCLUSIONS: Integrating BMT in this large FQHC network resulted in retention rates similarly reported in clinical trials and emphasizes the need for providing substance abuse counseling and screening for and treating psychiatric comorbidity.
Authors:
Marwan S Haddad; Alexei Zelenev; Frederick L Altice
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2013-01-17
Journal Detail:
Title:  Drug and alcohol dependence     Volume:  131     ISSN:  1879-0046     ISO Abbreviation:  Drug Alcohol Depend     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-05     Completed Date:  2014-01-27     Revised Date:  2014-07-02    
Medline Journal Info:
Nlm Unique ID:  7513587     Medline TA:  Drug Alcohol Depend     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  127-35     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Buprenorphine / administration & dosage*
Cohort Studies
Connecticut / epidemiology
Female
Humans
Longitudinal Studies
Maintenance Chemotherapy / methods*,  trends
Male
Middle Aged
Opioid-Related Disorders / diagnosis,  drug therapy*,  epidemiology*
Patient Protection and Affordable Care Act* / trends
Retrospective Studies
Substance Abuse Treatment Centers / methods*,  trends
Treatment Outcome
Young Adult
Grant Support
ID/Acronym/Agency:
K24 DA017072/DA/NIDA NIH HHS; K24 DA017072/DA/NIDA NIH HHS; P30 MH062294/MH/NIMH NIH HHS; R01 DA030768/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
40D3SCR4GZ/Buprenorphine
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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