TY - JOUR
KW - Adolescent
KW - Adult
KW - Buprenorphine/therapeutic use
KW - Cross-Sectional Studies
KW - Female
KW - Health Care Costs/statistics & numerical data
KW - Humans
KW - Male
KW - Medication Adherence/psychology/statistics & numerical data
KW - Opiate Substitution Treatment/methods/psychology
KW - Opioid-Related Disorders/drug therapy
KW - Recurrence
KW - Retrospective Studies
KW - Treatment Outcome
KW - Young Adult
AU - C. Ruetsch
AU - J. Tkacz
AU - V. R. Nadipelli
AU - B. L. Brady
AU - N. Ronquest
AU - H. Un
AU - J. Volpicelli
A1 - 
AB - OBJECTIVES: To examine patient characteristics and outcomes associated with nonadherence to buprenorphine and to identify specific patterns of nonadherent behavior. STUDY DESIGN: Cross-sectional, retrospective analysis of health claims data. METHODS: Aetna's administrative claims data were used to categorize incident opioid use disorder (OUD) patients based on buprenorphine medication possession ratio (MPR) into adherent (n = 172) and nonadherent (n = 305) groups. Adherent groups were then divided into 5 subgroups based on level of MPR, as well as 2 a priori-defined groups: intermittent adherent (IA) and early treatment discontinuation-no consequences (ETDNC). Groups were compared on patient characteristics and outcomes. RESULTS: Nonadherent members incurred significantly greater healthcare costs and were more likely to relapse (P <.05). The use of high-cost healthcare services increased as a function of decreasing MPR (P <.05). Assessment of the a priori groups revealed IA members to have outcomes similar to nonadherent patients, while ETDNC members exhibited outcomes similar to adherent members. CONCLUSIONS: Administrative claims can be used to define subgroups of buprenorphine-medication assisted treatment (B-MAT) patients. Nonadherence was related to an increased likelihood of relapse, and there is an inverse relationship between MPR and cost. The heterogeneity observed within this sample indicates that treatment regimens effective for 1 subgroup may not be appropriate for all OUD patients. Increased understanding of B-MAT nonadherent subgroups may facilitate development of new interventions and medications specifically designed for nonadherent B-MAT patients, potentially leading to improved outcomes and reduced costs of care.
AD - Health Analytics, LLC, 9200 Rumsey Rd, Ste 215, Columbia, MD 21045. E-mail: joseph.tkacz@healthanalytic.com.
BT - The American Journal of Managed Care
C5 - Financing & Sustainability; Opioids & Substance Use
CP - 6
CY - United States
IS - 6
JF - The American Journal of Managed Care
M1 - Journal Article
N2 - OBJECTIVES: To examine patient characteristics and outcomes associated with nonadherence to buprenorphine and to identify specific patterns of nonadherent behavior. STUDY DESIGN: Cross-sectional, retrospective analysis of health claims data. METHODS: Aetna's administrative claims data were used to categorize incident opioid use disorder (OUD) patients based on buprenorphine medication possession ratio (MPR) into adherent (n = 172) and nonadherent (n = 305) groups. Adherent groups were then divided into 5 subgroups based on level of MPR, as well as 2 a priori-defined groups: intermittent adherent (IA) and early treatment discontinuation-no consequences (ETDNC). Groups were compared on patient characteristics and outcomes. RESULTS: Nonadherent members incurred significantly greater healthcare costs and were more likely to relapse (P <.05). The use of high-cost healthcare services increased as a function of decreasing MPR (P <.05). Assessment of the a priori groups revealed IA members to have outcomes similar to nonadherent patients, while ETDNC members exhibited outcomes similar to adherent members. CONCLUSIONS: Administrative claims can be used to define subgroups of buprenorphine-medication assisted treatment (B-MAT) patients. Nonadherence was related to an increased likelihood of relapse, and there is an inverse relationship between MPR and cost. The heterogeneity observed within this sample indicates that treatment regimens effective for 1 subgroup may not be appropriate for all OUD patients. Increased understanding of B-MAT nonadherent subgroups may facilitate development of new interventions and medications specifically designed for nonadherent B-MAT patients, potentially leading to improved outcomes and reduced costs of care.
PP - United States
PY - 2017
SN - 1936-2692; 1088-0224
SP - e172
EP - e179
EP - 
T1 - Heterogeneity of nonadherent buprenorphine patients: subgroup characteristics and outcomes
T2 - The American Journal of Managed Care
TI - Heterogeneity of nonadherent buprenorphine patients: subgroup characteristics and outcomes
U1 - Financing & Sustainability; Opioids & Substance Use
U2 - 28817294
VL - 23
VO - 1936-2692; 1088-0224
Y1 - 2017
Y2 - Jun 1
ER -