Department of Psychiatry, VA Boston Healthcare System, West Roxbury, Massachusetts.
Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts.
Am J Addict. 2019 Sep;28(5):339-346. doi: 10.1111/ajad.12896. Epub 2019 May 8.
Despite high comorbidity between substance use disorders and other mental health diagnoses, there is a paucity of literature on buprenorphine treatment outcomes in outpatient mental health settings. This study aimed to identify rates and predictors of outpatient buprenorphine treatment retention in a Behavioral Health Clinic (BHC).
This retrospective cohort study of adults on buprenorphine used multiple logistic regression to identify clinical and demographic factors associated with 1- and 2-year treatment retention and buprenorphine adherence.
Of 321 subjects, 169 (52.6%) were retained in treatment for at least 1 year; 114 (35.5%) were retained for 2 years or more. Buprenorphine adherence was 95.8% and 97.3% for 1- and 2-year retention groups, respectively. Predictors of 1-year retention included benzodiazepine co-prescription (adjusted odds ratio [AOR] = 2.4; 95% CI [1.30, 4.55]), having a diagnosis of other mood disorder (AOR = 3.4; [1.95, 5.98]), or nicotine use disorder (AOR = 2.4; [1.35, 4.27]). Predictors of 2-year retention included female gender (AOR = 2.1; [1.16, 3.73]), having a diagnosis of depressive disorder (AOR = 4.6; [1.49, 14.29]), other mood disorder (AOR = 3.6; [1.88, 6.88]), or nicotine use disorder (AOR = 2.0; [1.13, 3.52]).
During the study period, 52.7% and 35.5% of BHC patients treated with buprenorphine were retained for 1 and 2 years, respectively, comparable to the studies performed within primary care. Providing buprenorphine treatment within mental health clinics may serve patients who are already engaged with mental health providers but are reluctant to start new treatment within another treatment setting.
Identifying common predictors of retention can help determine which patients require additional substance use treatment support. (Am J Addict 2019;28:339-346).
尽管物质使用障碍与其他心理健康诊断之间存在高度共病，但关于门诊心理健康环境中丁丙诺啡治疗结果的文献却很少。本研究旨在确定行为健康诊所（BHC）中门诊丁丙诺啡治疗保留率的比率和预测因素。
这项对丁丙诺啡使用者的回顾性队列研究使用多项逻辑回归来确定与 1 年和 2 年治疗保留率以及丁丙诺啡依从性相关的临床和人口统计学因素。
在 321 名受试者中，有 169 名（52.6％）至少接受了 1 年的治疗保留；114 名（35.5％）保留了 2 年或更长时间。丁丙诺啡的依从率分别为 1 年和 2 年保留组的 95.8％和 97.3％。1 年保留的预测因素包括苯二氮卓类药物联合处方（调整后的优势比[OR] = 2.4；95％置信区间[CI] [1.30，4.55]），其他心境障碍诊断（OR = 3.4；[1.95，5.98]）或尼古丁使用障碍（OR = 2.4；[1.35，4.27]）。2 年保留的预测因素包括女性（OR = 2.1；[1.16，3.73]），抑郁障碍诊断（OR = 4.6；[1.49，14.29]），其他心境障碍（OR = 3.6；[1.88，6.88]）或尼古丁使用障碍（OR = 2.0；[1.13，3.52]）。
在研究期间，BHC 中接受丁丙诺啡治疗的患者中有 52.7％和 35.5％分别保留了 1 年和 2 年，这与在初级保健中进行的研究相似。在心理健康诊所中提供丁丙诺啡治疗可能可以为已经与心理健康提供者接触但不愿在另一个治疗环境中开始新治疗的患者提供服务。
确定保留的常见预测因素有助于确定需要额外的物质使用治疗支持的患者。（美国成瘾杂志 2019;28:339-346）。
