title: Determinants of buprenorphine treatment for opioid dependence.
abstract: This study assessed the social, demographic and clinical determinants of whether an opioid-dependent patient received buprenorphine versus an alternative therapy. A retrospective cohort analysis of opioid-dependent adults enrolled in Group Health Cooperative between January 1, 2006 and December 1, 2010 was performed. Increasing the number of physicians with DATA waivers in a region and living in a relatively-populated area increased the likelihood of being treated with buprenorphine, indicating that lack of access is a potential barrier. Comorbidity also appeared to be a factor in receipt of treatment, with the effect varying by diagnosis. Finally, patients with an insurance plan allowing health services to be sought from any provider, with increased cost sharing, were significantly more likely to receive buprenorphine, implying that patient demand is a factor. Programs integrating patient education, physician training, and support from addiction specialists would be likely facilitators of increasing access to this cost-effective treatment.
authors.affiliation: Department of Health Policy and Administration, Washington State University, P.O. Box 1495, Spokane, WA 99210-1495, USA. Electronic address: sean.murphy@wsu.edu.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Murphy
authors.affiliation: Group Health Research Institute, Seattle, WA 98101, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Fishman
authors.affiliation: College of Nursing, Washington State University, Spokane, WA 99210-1495, USA.
authors.forename: Sterling
authors.initials: S
authors.lastname: McPherson
authors.affiliation: Washington State University, Spokane, WA 99210-1495, USA.
authors.forename: Dennis G
authors.initials: DG
authors.lastname: Dyck
authors.affiliation: Washington State University, Spokane, WA 99210-1495, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Roll
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002047:Buprenorphine / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine
keywords: Buprenorphine; Opioid dependence; Treatment determinants