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The following is a summary of “Predicting buprenorphine adherence among patients with opioid use disorder in primary care settings,” published in the October 2024 issue of Primary Care by Hooker et al.

Buprenorphine is a key medication used to treat opioid use disorder (OUD) and can reduce the risks of overdose and death. It is often prescribed in outpatient primary care settings, yet previous studies have indicated low adherence to buprenorphine in these environments. 

For a study, researchers aimed to identify adherence rates and factors associated with buprenorphine adherence during the first six months following the initiation of the treatment. They analyzed data from the electronic health records of 345 patients with OUD (average age: 37.6 years; 61.7% male; 78% White) who began buprenorphine treatment between March 2019 and July 2021 within a large integrated health system in the upper Midwest. Adherence was measured by the proportion of days covered (PDC) with a standard cut-off of 80%, categorizing patients as either adherent or non-adherent. 

Demographic, service-related, and clinical factors such as age, sex, race, urine toxicology results, and buprenorphine dosage were examined to determine their potential impact on adherence.

The results revealed that less than half of the patients (44%) were adherent to buprenorphine during the six-month period. Male patients (OR = 0.34, p < .001) and those who had unexpected positive opioid results in urine screens (OR = 0.42, p = .014) were less likely to adhere to buprenorphine. In contrast, former smokers were more likely to adhere to treatment compared to current smokers (OR = 1.82, p = .014).

Researchers concluded that buprenorphine adherence in primary care settings remains low, and specific factors like gender and smoking history may play a role in adherence patterns. Further research is needed to explore the underlying mechanisms of these associations and to develop strategies that improve adherence to buprenorphine in patients with opioid use disorder.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02609-9