Wang Yun, Chan Alexandre, Beuttler Richard, Fleming Marc L, Schneberk Todd, Nichol Michael, Lu Haibing
School of Pharmacy, Chapman University, Irvine, CA 92618, USA.
Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, CA 92697, USA.
Healthcare (Basel). 2024 Jan 18;12(2):241. doi: 10.3390/healthcare12020241.
The opioid overdose crisis in the United States has become a significant national emergency. Buprenorphine, a primary medication for individuals coping with opioid use disorder (OUD), presents promising pharmacokinetic properties for use in primary care settings, and is often delivered as a take-home therapy. The COVID-19 pandemic exacerbated the scarcity of access to buprenorphine, leading to dire consequences for those with OUD. Most existing studies, primarily focused on the immediate aftermath of the COVID-19 outbreak, highlight the challenges in accessing medications for opioid use disorder (MOUDs), particularly buprenorphine. However, these studies only cover a relatively short timeframe.
To bridge this research gap, in our study, we utilized 33 months of California's prescription drug monitoring program (PDMP) data to provide insights into real-world buprenorphine dispensing trends since the onset of the pandemic from 2018 to 2021, focusing on outcomes such as patient counts, prescription volumes, prescriber involvement, days' supply, and dosage. Statistical analysis employed interrupted time series analysis to measure changes in trends before and during the pandemic.
We found no significant impact on patient counts or prescription volumes during the pandemic, although it impeded the upward trajectory of prescriber numbers that was evident prior to the onset of the pandemic. An immediate increase in days' supply per prescription was observed post-pandemic.
Our findings differ in comparison to previous data regarding the raw monthly count of patients and prescriptions. The analysis encompassed uninsured patients, offering a comprehensive perspective on buprenorphine prescribing in California. Our study's insights contribute to understanding the impact of COVID-19 on buprenorphine access, emphasizing the need for policy adjustments.
美国的阿片类药物过量危机已成为重大的国家紧急情况。丁丙诺啡是用于治疗阿片类药物使用障碍（OUD）患者的主要药物，具有良好的药代动力学特性，适用于初级保健环境，通常作为家庭治疗药物提供。2019年冠状病毒病（COVID-19）大流行加剧了丁丙诺啡获取的稀缺性，给患有阿片类药物使用障碍的人带来了可怕的后果。大多数现有研究主要关注COVID-19疫情爆发后的直接后果，突出了获取阿片类药物使用障碍药物（MOUDs），尤其是丁丙诺啡方面的挑战。然而，这些研究仅涵盖了相对较短的时间范围。
为了弥补这一研究空白，在我们的研究中，我们利用了加利福尼亚州33个月的处方药监测计划（PDMP）数据，以深入了解自2018年至2021年大流行开始以来丁丙诺啡在现实世界中的配药趋势，重点关注患者数量、处方量、开处方者参与情况、供应天数和剂量等结果。统计分析采用中断时间序列分析来衡量大流行之前和期间趋势的变化。
我们发现大流行期间对患者数量或处方量没有显著影响，尽管它阻碍了大流行开始前明显的开处方者数量的上升趋势。大流行后观察到每张处方的供应天数立即增加。
我们的研究结果与之前关于患者和处方每月原始计数的数据有所不同。该分析涵盖了未参保患者，提供了加利福尼亚州丁丙诺啡处方的全面视角。我们研究的见解有助于理解COVID-19对丁丙诺啡获取的影响，强调了政策调整的必要性。
