TY - JOUR
KW - Adult
KW - Analgesics, Opioid/therapeutic use
KW - Buprenorphine/therapeutic use
KW - Chronic Pain/drug therapy
KW - Cooperative Behavior
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Opioid-Related Disorders/drug therapy
KW - Patient Care Management
KW - Primary Health Care
AU - J. Suzuki
AU - M. L. Matthews
AU - D. Brick
AU - M. T. Nguyen
AU - A. D. Wasan
AU - R. N. Jamison
AU - A. L. Ellner
AU - L. W. Tishler
AU - R. D. Weiss
A1 - 
AB - OBJECTIVE: To implement a collaborative care management program with buprenorphine in a primary care clinic. DESIGN: Prospective observational study. SETTING: A busy urban academic primary care clinic affiliated with a tertiary care hospital. PARTICIPANTS: Opioid-dependent patients or patients with chronic pain using opioids nonmedically were recruited for the study. A total of 45 participants enrolled. INTERVENTIONS: Patients were treated with buprenorphine and managed by a supervising psychiatrist, pharmacist care manager, and health coaches. The care manager conducted buprenorphine inductions and all follow-up visits. Health coaches offered telephonic support. The psychiatrist supervised both the care manager and health coaches. MAIN OUTCOME MEASURES: Primary outcomes were treatment retention at 6 months, and change in the proportion of aberrant toxicology results and opioid craving scores from baseline to 6 months. After data collection, clinical outcomes were compared between opioid-dependent patients and patients with chronic pain using opioids nonmedically. Overall, 55.0 percent of participants (25/45) remained in treatment at 6 months. Primary care physicians (PCPs)' attitudes about opioid dependence treatment were surveyed at baseline and at 18 months. RESULTS: Forty-three patients (95.6 percent) accepted treatment and 25 (55.0 percent) remained in treatment at 6 months. The proportion of aberrant urine toxicology results decreased significantly from baseline to 6 months (p < 0.01). Craving scores significantly decreased from baseline to 6 months (p < 0.01). Opioid-dependent patients, as opposed to patients with chronic pain using opioids nonmedically, were significantly more likely to complete 6 months of treatment (p < 0.05). PCPs' confidence in treating opioid dependence in primary care increased significantly from baseline to 18 months postimplementation (p < 0.01). CONCLUSION: Collaborative care management for opioid dependence with buprenorphine may be feasible in a primary care clinic. More research is needed to understand the role of buprenorphine in managing patients with chronic pain using opioids nonmedically.
BT - Journal of opioid management
C5 - Opioids & Substance Use
CP - 3
CY - United States
DO - 10.5055/jom.2014.0204
IS - 3
JF - Journal of opioid management
N2 - OBJECTIVE: To implement a collaborative care management program with buprenorphine in a primary care clinic. DESIGN: Prospective observational study. SETTING: A busy urban academic primary care clinic affiliated with a tertiary care hospital. PARTICIPANTS: Opioid-dependent patients or patients with chronic pain using opioids nonmedically were recruited for the study. A total of 45 participants enrolled. INTERVENTIONS: Patients were treated with buprenorphine and managed by a supervising psychiatrist, pharmacist care manager, and health coaches. The care manager conducted buprenorphine inductions and all follow-up visits. Health coaches offered telephonic support. The psychiatrist supervised both the care manager and health coaches. MAIN OUTCOME MEASURES: Primary outcomes were treatment retention at 6 months, and change in the proportion of aberrant toxicology results and opioid craving scores from baseline to 6 months. After data collection, clinical outcomes were compared between opioid-dependent patients and patients with chronic pain using opioids nonmedically. Overall, 55.0 percent of participants (25/45) remained in treatment at 6 months. Primary care physicians (PCPs)' attitudes about opioid dependence treatment were surveyed at baseline and at 18 months. RESULTS: Forty-three patients (95.6 percent) accepted treatment and 25 (55.0 percent) remained in treatment at 6 months. The proportion of aberrant urine toxicology results decreased significantly from baseline to 6 months (p < 0.01). Craving scores significantly decreased from baseline to 6 months (p < 0.01). Opioid-dependent patients, as opposed to patients with chronic pain using opioids nonmedically, were significantly more likely to complete 6 months of treatment (p < 0.05). PCPs' confidence in treating opioid dependence in primary care increased significantly from baseline to 18 months postimplementation (p < 0.01). CONCLUSION: Collaborative care management for opioid dependence with buprenorphine may be feasible in a primary care clinic. More research is needed to understand the role of buprenorphine in managing patients with chronic pain using opioids nonmedically.
PP - United States
PY - 2014
SN - 1551-7489; 1551-7489
SP - 159
EP - 168
EP - 
T1 - Implementation of a collaborative care management program with buprenorphine in primary care: A comparison between opioid-dependent patients and patients with chronic pain using opioids nonmedically
T2 - Journal of opioid management
TI - Implementation of a collaborative care management program with buprenorphine in primary care: A comparison between opioid-dependent patients and patients with chronic pain using opioids nonmedically
U1 - Opioids & Substance Use
U2 - 24944066
U3 - 10.5055/jom.2014.0204
VL - 10
VO - 1551-7489; 1551-7489
Y1 - 2014
ER -