Friday, November 22, 2019

Monthly Buprenorphine May Improve OUD Patients’ Sense of Well-Being, Satisfaction With Treatment

A study in the Journal of Substance Abuse Treatment has shown that treating patients with opioid use disorder (OUD) with monthly injections of extended-release buprenorphine may result in measurable improvements in patients’ quality of life and sense of well-being. This represents a departure from standard research on OUD treatment, which largely focuses on how long patients remain in treatment and whether they abstain from illicit opioid use, according to the researchers.

“Outcomes that are easily measurable during office visits can help clinicians assess life changes reflective of a person’s recovery—a lifestyle characterized not only by abstinence but also health and return to normality,” wrote Walter Ling, M.D., of the University of California, Los Angeles, and colleagues.

In the 12-month study, 206 patients between 18 and 65 years old with moderate to severe OUD received monthly injections of extended-release buprenorphine. Researchers used standard assessment tools and questionnaires at various intervals throughout the study to measure how the patients felt about their own well-being. These tools included the following:

  • The EQ-5D-5L to measure the patients’ sense of health such as mobility, self-care, daily activities, pain and discomfort, and anxiety and depression.
  • The SF-36v2 to measure the patients’ sense of health-related quality of life and physical and mental health.
  • The Treatment Effectiveness Assessment to assess the patients’ perception of treatment effectiveness.
  • The Addiction Severity Index-Lite to assess challenging treatment areas, medical, family/social, or psychiatric issues, employment/support status, alcohol use, drug use, and legal issues.
  • The Medication Satisfaction Questionnaire to assess the patients’ satisfaction with their treatment.

At the end of the study, the patients’ scores had remained stable on the EQ-5d-5L and the physical component of the SF-36v2. However, their scores rose in the mental health component of the SF-36v2, which suggests that they felt their mental health had improved. The patients’ scores also rose an average of 9 points on the Treatment Effectiveness Assessment, which suggests that they felt the treatment was working. Their scores on the Addiction Severity Index-Lite improved for every measure except alcohol use, and their employment rate increased 7%. At the end of the study, 89% of participants stated they were satisfied with treatment on the Medication Satisfaction Questionnaire.

The researchers noted one important caveat in their study: 412 patients had originally enrolled, but half had withdrawn before the study was over. However, the researchers added that this dropout rate was comparable to that of 11 other studies on buprenorphine treatment.

“Results from this long-term study show positive patient-centered outcomes and high treatment satisfaction for participants initiating and receiving up to 12 months of [extended-release buprenorphine] treatment during the open-label study, demonstrating that meaningful life changes are measurable during a person's recovery journey,” they concluded.

For related information, see the Psychiatric News article “Multidisciplinary Teams Knock Down Barriers to Medication Treatment for OUD.”

This work was funded by Indivior Inc., who manufactures Sublocade, the extended-release buprenorphine medication used in this trial.

(Image: iStock/Moussa81)

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