Thursday, May 13, 2021

Patients Report Greater Satisfaction With Extended-Release Over Daily Buprenorphine

Patients with opioid dependence who received weekly or monthly buprenorphine injections reported greater satisfaction compared with patients who took oral buprenorphine daily, according to a study in JAMA Network Open. The results highlight the importance of using patient-reported outcomes when developing medication treatment for substance use disorders.

“Long-acting injectable depot buprenorphine formulations have been developed to mitigate some of the concerns of daily dosing,” but few studies have compared the patients’ experiences with the injectable versus oral form of the medication, wrote Nicholas Lintzeris, M.B.B.S., Ph.D., of the University of Sydney Discipline of Addiction Medicine in Australia and colleagues.

Lintzeris and colleagues conducted an open-label trial involving 119 participants aged 18 and older, recruited from six outpatient clinical sites in Australia. All participants met the criteria for opioid dependence according to ICD-10 and were receiving daily buprenorphine before the study began. They were randomized to receive either weekly or monthly injections of extended-release buprenorphine or daily oral buprenorphine as a film formulation. Those who received the extended-release buprenorphine were administered injections of the medication with a maximum weekly dose of 32 mg or a maximum monthly dose of 160 mg. Those who received daily buprenorphine were administered a maximum daily dose of 32 mg.

Participants completed the Treatment Satisfaction Questionnaire for Medication (TSQM) at baseline and at weeks four, eight, 12, 16, 20, and 24. Higher scores indicated greater satisfaction with treatment. By week 24, the depot buprenorphine group expressed significantly higher satisfaction compared with the group receiving daily buprenorphine. The mean TSQM scores at baseline were 71.2 in the depot buprenorphine group and 73.8 in the daily group, but at 24 weeks the mean scores were 82.5 and 74.3, respectively.

In an accompanying commentary, Nora Volkow, M.D., director of the National Institute on Drug Abuse (NIDA), and Wilson Compton, M.D., M.P.E., deputy director of NIDA, noted the importance of including the voice of the patient in medication development. “Patient preferences and apparently improved function may prove to be useful secondary outcomes in medication trials, and the measures used in this new study deserve consideration,” they wrote.

They continued: “[T]he greater treatment satisfaction by patients receiving [extended-release] buprenorphine suggests that [extended-release] formulations might help to improve long-term retention and, as such, be a valuable tool to help combat the current opioid epidemic and reduce its associated mortality,” Volkow and Compton wrote.

For related information, see the Psychiatric News article “Factors to Consider Before Prescribing Buprenorphine.”

(Image: iStock/Alernon77)


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