title: Opiate maintenance with buprenorphine in ambulatory care: a 24-week follow-up study of new users.
abstract: 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.
authors.affiliation: 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
authors.forename: M
authors.initials: M
authors.lastname: Lapeyre-Mestre
authors.forename: M-E
authors.initials: ME
authors.lastname: Llau
authors.forename: M
authors.initials: M
authors.lastname: Gony
authors.forename: A-M
authors.initials: AM
authors.lastname: Navel
authors.forename: J
authors.initials: J
authors.lastname: Bez
authors.forename: M
authors.initials: M
authors.lastname: Grau
authors.forename: J-L
authors.initials: JL
authors.lastname: Montastruc
mesh_terms: 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
chemical_list: D009294:Narcotics; D002047:Buprenorphine