title: Factors affecting noncompliance with buprenorphine maintenance treatment.
abstract: BACKGROUND
  The current study aimed to identify risk factors for treatment noncompliance in a sample of veterans receiving buprenorphine/naloxone for an opioid use disorder.
  
  
  METHODS
  Records from all patients who are currently or had previously been maintained on buprenorphine in the buprenorphine maintenance treatment program at the Atlanta VA Medical Center during the years 2006 to 2013 were evaluated. Of the 209 patients treated in the clinic between 2006 and 2013, 140 were excluded from the study because they did not have a call-back done at the time of data collection. Thus, 69 patient charts were selected for review.
  
  
  RESULTS
  The multiple linear regression analysis of the predictable variables for noncompliance with the buprenorphine pill count showed that positive urine drug screen (UDS) for marijuana, benzodiazepines, and being a smoker (F = 3.08; P = 0.03) are significantly associated with noncompliance with buprenorphine pill count.Also, the multiple linear regression analysis of the predictable variables for noncompliance with the buprenorphine pill count showed that the psychiatric comorbidity independently (F = 4.88; P = 0.03) is significantly associated with noncompliance with buprenorphine pill count.
  
  
  CONCLUSIONS
  Patients found to be noncompliant were more likely to suffer from comorbid psychiatric illness. Patients who tested positive for benzodiazepines or cannabis were more likely to be noncompliant with treatment. Although the rate of noncompliance (inaccurate pill count) was high, patients were still found to be taking their prescribed buprenorphine as evidenced by positive UDS for buprenorphine/norbuprenorphine. In addition, our sample had a high rate of negative UDS screens for opioids and cocaine.
authors: From the Department of Psychiatry (AF, PE, KD), Emory University School of Medicine, Atlanta, GA; Atlanta VA Medical Center (AF, PE, BK, AMB-C, KC, HSH, KD), Decatur, GA; Department of Psychiatry and Behavioral Sciences (KS, AN), Emory University School of Medicine, Atlanta, GA; and Department of Psychiatry (HSH), Morehouse School of Medicine, Atlanta, GA.
authors: Ayman
authors: A
authors: Fareed
authors: Pamela
authors: P
authors: Eilender
authors: Bethany
authors: B
authors: Ketchen
authors: Ann Marie
authors: AM
authors: Buchanan-Cummings
authors: Kelly
authors: K
authors: Scheinberg
authors: Kelli
authors: K
authors: Crampton
authors: Abigail
authors: A
authors: Nash
authors: Hilaire
authors: H
authors: Shongo-Hiango
authors: Karen
authors: K
authors: Drexler
mesh_terms: D002047:Buprenorphine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000523:psychology; D009293:Opioid-Related Disorders / Q000150:complications / Q000188:drug therapy; D012307:Risk Factors; D012907:Smoking / Q000523:psychology; D019966:Substance-Related Disorders / Q000150:complications; D016903:Drug Monitoring
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine