Opiate maintenance with buprenorphine in ambulatory care: a 24-week follow-up study of new users.
BACKGROUND
Many studies suggest that buprenorphine, a long acting partial opioid agonist, may be comparable to methadone in efficacy, with fewer withdrawal symptoms and a lower risk of overdose. The aim of this study was to assess the patterns of buprenorphine prescription use in ambulatory care and retention rate under treatment during a 24-week follow-up period.


METHODS
This observational cohort study included buprenorphine users identified from the French Health System prescription database in an area of 1 million inhabitants and followed for 24 weeks.


RESULTS
We selected 282 users of buprenorphine defined as "new users" (74% male, mean age 32.4+/-6.2 years). Three groups were defined: 50% of "rational users" (141 subjects, no more than 2 prescribers), 24% of "occasional users" (67 subjects, less than 2 buprenorphine prescriptions) and 26% of "non-rational users" (74 subjects, 3 or more prescribers). The overall 24-week treatment retention rate was 37%. Misuse of buprenorphine or benzodiazepines was significantly more frequent in "non-rational" than "rational users".


CONCLUSIONS
The retention rate with buprenorphine estimated in this observational study was very similar to that obtained in controlled trials. A majority of regular users of buprenorphine could be regarded as "rational users" in this area of France.
Lapeyre-Mestre
M
M
EA 3696, Unit of Pharmacoepidemiology, Department of Clinical Pharmacology, Centre d'Evaluation et d'Information sur la Pharmacodependance, 37 Allees Jules Guesde, 31073 Toulouse 7,France. lapeyre@cict.fr
Llau
M-E
ME
Gony
M
M
Navel
A-M
AM
Bez
J
J
Grau
M
M
Montastruc
J-L
JL
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D002047:Buprenorphine / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D010349:Patient Compliance; D010352:Patient Dropouts; D013997:Time Factors; D016896:Treatment Outcome
D009294:Narcotics; D002047:Buprenorphine