Counseling as a complement to buprenorphine treatment for opioid use disorder: A retrospective observational study of patient outcomes

0 PSYCHOLOGY, CLINICAL

Journal of substance use and addiction treatment Pub Date : 2025-05-08 DOI:10.1016/j.josat.2025.209719

Tianjie Zhu , Md. Noor-E-Alam , Md Mahmudul Hasan , Leonard D. Young , Gary J. Young

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Abstract

Introduction

This study investigated the clinical benefit of counseling as a complement to buprenorphine treatment for opioid use disorder (OUD). The research addresses a critical gap in understanding whether counseling, when received concurrently with buprenorphine, can enhance patient outcomes.

Methods

We conducted a retrospective cohort study using data from the Massachusetts Department of Public Health's Public Health Data Warehouse (PHD). The study included patients who initiated buprenorphine treatment between January 2015 and December 2019. Investigators measured outcomes including medication adherence, treatment discontinuation, and opioid-related overdose over a 12-month period. We evaluated the effectiveness of counseling based on whether patients attended a minimum of three sessions in the first three months of buprenorphine treatment. We employed multivariate logistic regression and propensity score matching to analyze the data.

Results

The study sample comprised 32,688 patients with 8871 (27 %) receiving counseling concomitantly with buprenorphine. Results from the regression analyses showed that counseling was associated with 17 % lower likelihood of poor medication continuity (OR = 0.83, 95 % CI = 0.78–0.87) and 21 % lower likelihood of treatment discontinuation (OR = 0.79, 95 % CI = 0.75–0.83). Counseling was not associated with the odds of opioid-related overdose. Additional results from sensitivity analyses pointed to a dose-response relationship for counseling within the parameters studied.

Conclusions

Findings suggest that counseling, when combined with buprenorphine treatment for OUD is associated with better patient outcomes in terms of medication continuity and treatment retention. However, the impact of counseling on opioid-related overdose risk was inconclusive, highlighting the need for further research to understand its role in overdose prevention.

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咨询作为阿片类药物使用障碍丁丙诺啡治疗的补充：一项对患者结果的回顾性观察研究。

本研究调查了咨询作为丁丙诺啡治疗阿片类药物使用障碍（OUD）的补充的临床益处。该研究解决了理解咨询与丁丙诺啡同时接受是否可以提高患者预后的关键差距。方法：我们使用马萨诸塞州公共卫生部公共卫生数据仓库（PHD）的数据进行了一项回顾性队列研究。该研究包括在2015年1月至2019年12月期间开始丁丙诺啡治疗的患者。研究人员在12个月的时间里测量了包括药物依从性、治疗中断和阿片类药物过量在内的结果。我们根据患者在丁丙诺啡治疗的前三个月是否至少参加了三次会议来评估咨询的有效性。我们采用多元逻辑回归和倾向评分匹配对数据进行分析。结果：研究样本包括32,688例患者，其中8871例（27% %）接受咨询同时服用丁丙诺啡。回归分析的结果表明,咨询与17 %降低贫困的可能性药物连续性(或 = 0.83,95 CI  % = 0.78 - -0.87)和21 %降低治疗停药的可能性(或 = 0.79,95 CI  % = 0.75 - -0.83)。咨询与阿片类药物过量的几率无关。敏感性分析的其他结果指出，在所研究的参数范围内，咨询的剂量-反应关系。结论：研究结果表明，咨询与丁丙诺啡联合治疗OUD在药物连续性和治疗保留方面具有更好的患者预后。然而，咨询对阿片类药物相关过量风险的影响尚无定论，这突出表明需要进一步研究以了解其在过量预防中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of substance use and addiction treatment Biological Psychiatry, Neuroscience (General), Psychiatry and Mental Health, Psychology (General)

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