Uptake of Low-dose Buprenorphine Initiation and Associated Patient Characteristics in British Columbia, Canada: A Population-based Cohort Study.

IF 4.2 3区医学 Q1 SUBSTANCE ABUSE

Journal of Addiction Medicine Pub Date : 2025-03-27 DOI:10.1097/ADM.0000000000001483

Nikki Bozinoff, Jingxin Lei, Tamara Mihic, Jessica Moe, Heather Palis, Seonaid Nolan, Lianping Ti, Mary Clare Kennedy

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引用次数: 0

Abstract

Objectives: To characterize patterns of outpatient buprenorphine induction and examine factors associated with the use of low-dose initiation (LDI).

Methods: A retrospective cohort study of 4510 adults initiating buprenorphine between January 1, 2016 and December 31, 2019 in British Columbia (BC), Canada, was undertaken using linked administrative data in the Provincial Overdose Cohort, which contains a 20% random sample of BC residents. Using multivariable modelling, we examined the association between sociodemographic, co-morbidity, treatment, and health service utilization variables, and the outcome of LDI. Joinpoint analysis was also conducted to assess inflection points in the prevalence of this practice.

Results: Overall, 7.2% of included buprenorphine inductions during the study period were classified as LDI. Joinpoint analysis revealed that the percentage of buprenorphine inductions classified as LDI increased significantly beginning in the fourth quarter of 2017. In multivariable analyses, factors positively associated with LDI included: older age (adjusted odds ratio [aOR]: 1.01, 95% CI: 1.00-1.02), living in Vancouver Coastal (aOR: 1.53, 95% CI: 1.13-2.06) and Fraser Health Authority regions (aOR: 2.56, 95% CI: 1.89-3.48) (vs interior region); having been prescribed slow-release oral morphine for opioid use disorder in the last 3 years (aOR: 4.03, 95% CI: 2.51-6.49), and having 1 (aOR: 2.40, 95% CI: 1.80-3.20) or ≥2 (vs 0) opioid agonist treatment episodes in the last 5 years (aOR: 2.56, 95% CI: 1.89-3.48). Factors negatively associated with microinduction included: male sex (aOR: 0.50, 95% CI:0.41-0.61), alcohol use disorder (aOR: 0.62, 95% CI: 0.40-0.96), injection drug use (aOR: 0.75, 95% CI: 0.61-0.94) and past-year incarceration (aOR: 0.19, 95% CI: 0.10-0.33).

Conclusions: The use of LDI has increased in BC in recent years. Markers of treatment experience were positively associated with receipt of LDI. A ssessment of outcomes associated with LDI is needed.

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来源期刊

Journal of Addiction Medicine 医学-药物滥用

CiteScore

6.10

自引率

9.10%

发文量

260

审稿时长

>12 weeks

期刊介绍： The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.