{"doi":"10.1192/j.eurpsy.2022.2116","title":"Personalized Care in Opioid Use Disorder maintained on Buprenorphine","abstract":"<jats:sec id=\"S0924933822021162_sec15318\" sec-type=\"intro\"><jats:title>Introduction</jats:title><jats:p>Effectiveness of buprenorphine (BUP) is moderated by medication misuse diversion and non-adherence, and poor retention and high cost. Contingency Managment has added benefit to BUP with Take-home doses as the most preferred reward by Opioid Use Disorder patients.</jats:p></jats:sec><jats:sec id=\"S0924933822021162_sec15319\"><jats:title>Objectives</jats:title><jats:p>Examine the clinical effectiveness of a novel incentivised medication adherence and abstinence monitoring to enable contingent access to increasing BUP take-home doses.Explore associations with opioid use and retention. Contrast characteristics of polysubstance abusers (PSA) and response to BUP, with single opioid users.</jats:p></jats:sec><jats:sec id=\"S0924933822021162_sec15320\" sec-type=\"methods\"><jats:title>Methods</jats:title><jats:p>Two-arm, pragmatic, 16-week outpatient RCT of BUP maintenance.Takehome doses were provided as stepped-approach upto 4-weeks contingent of abstinence (UDS) and adherence according to Therapeutic Drug Monitoring-TDM. Primary outcome and secondard outcomes were % negative UDS for opioids anx retention, respectively. -</jats:p></jats:sec><jats:sec id=\"S0924933822021162_sec15321\" sec-type=\"results\"><jats:title>Results</jats:title><jats:p>Opioid % negative UDS was 76.7% (SD 25.0%) in I-AAM versus 63.5% (SD 34.7%) in TAU (13.3%; 95% [CI] 3.2%–23.3%; Cohen’s d 0.44; 95% CI 0.10–0.87). In I-AAM, 40 participants (57.1%) were retained versus 33 (46.4%) in TAU [OR: 1.54; 95% CI 0.79–2.98). PSA (73.7%, n=104) and carisprodol use increases non-fatal overdose (OR) 3.83, 95% CI 1.25 to 11.71) and 5.31, 95% CI 1.92 to 14.65], respectively. Opioid and non-opioid UDS are positively associated. BUP elimination rate (BUP-EL.R) predicts 26.5% to 65% of negative opioid UDS [Beta - 89.95, 95% CIl -154.20 to -25.70, R2 0.22]. Family enagement increases retention by 3-fold.</jats:p></jats:sec><jats:sec id=\"S0924933822021162_sec15322\" sec-type=\"conclusions\"><jats:title>Conclusions</jats:title><jats:p>BUP + incentivised TDM for contingent access to increasing take-home doses increased abstinence. BUP-EL.R seems promising in BUP treatment precision and BUP is clinically valuable in polysubstance abusers.Engaging family enhances retention.</jats:p></jats:sec><jats:sec id=\"S0924933822021162_sec15323\"><jats:title>Disclosure</jats:title><jats:p>No significant relationships.</jats:p></jats:sec>","journal":"European Psychiatry","year":2022,"id":647503,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1687037,"name":"J. Marsden","orcid":null,"position":1,"is_corresponding":false},{"id":1687039,"name":"H. Alghafri","orcid":null,"position":2,"is_corresponding":false},{"id":1687040,"name":"A. Adem","orcid":null,"position":3,"is_corresponding":false},{"id":1495519,"name":"A. Lee","orcid":"0009-0003-8471-8502","position":4,"is_corresponding":false},{"id":1687035,"name":"H. Elarabi","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Personalized Care in Opioid Use Disorder maintained on Buprenorphine","abstract":"<jats:sec id=\"S0924933822021162_sec15318\" sec-type=\"intro\"><jats:title>Introduction</jats:title><jats:p>Effectiveness of buprenorphine (BUP) is moderated by medication misuse diversion and non-adherence, and poor retention and high cost. Contingency Managment has added benefit to BUP with Take-home doses as the most preferred reward by Opioid Use Disorder patients.</jats:p></jats:sec><jats:sec id=\"S0924933822021162_sec15319\"><jats:title>Objectives</jats:title><jats:p>Examine the clinical effectiveness of a novel incentivised medication adherence and abstinence monitoring to enable contingent access to increasing BUP take-home doses.Explore associations with opioid use and retention. Contrast characteristics of polysubstance abusers (PSA) and response to BUP, with single opioid users.</jats:p></jats:sec><jats:sec id=\"S0924933822021162_sec15320\" sec-type=\"methods\"><jats:title>Methods</jats:title><jats:p>Two-arm, pragmatic, 16-week outpatient RCT of BUP maintenance.Takehome doses were provided as stepped-approach upto 4-weeks contingent of abstinence (UDS) and adherence according to Therapeutic Drug Monitoring-TDM. Primary outcome and secondard outcomes were % negative UDS for opioids anx retention, respectively. -</jats:p></jats:sec><jats:sec id=\"S0924933822021162_sec15321\" sec-type=\"results\"><jats:title>Results</jats:title><jats:p>Opioid % negative UDS was 76.7% (SD 25.0%) in I-AAM versus 63.5% (SD 34.7%) in TAU (13.3%; 95% [CI] 3.2%–23.3%; Cohen’s d 0.44; 95% CI 0.10–0.87). In I-AAM, 40 participants (57.1%) were retained versus 33 (46.4%) in TAU [OR: 1.54; 95% CI 0.79–2.98). PSA (73.7%, n=104) and carisprodol use increases non-fatal overdose (OR) 3.83, 95% CI 1.25 to 11.71) and 5.31, 95% CI 1.92 to 14.65], respectively. Opioid and non-opioid UDS are positively associated. BUP elimination rate (BUP-EL.R) predicts 26.5% to 65% of negative opioid UDS [Beta - 89.95, 95% CIl -154.20 to -25.70, R2 0.22]. Family enagement increases retention by 3-fold.</jats:p></jats:sec><jats:sec id=\"S0924933822021162_sec15322\" sec-type=\"conclusions\"><jats:title>Conclusions</jats:title><jats:p>BUP + incentivised TDM for contingent access to increasing take-home doses increased abstinence. BUP-EL.R seems promising in BUP treatment precision and BUP is clinically valuable in polysubstance abusers.Engaging family enhances retention.</jats:p></jats:sec><jats:sec id=\"S0924933822021162_sec15323\"><jats:title>Disclosure</jats:title><jats:p>No significant relationships.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"19162232","pmcid":"PMC9567902","openalex_id":"https://openalex.org/W4294201309","authors":[],"funders":[],"total_grants":0,"fwci":0.0,"citation_percentile":0.15152363,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.cambridge.org/core/services/aop-cambridge-core/content/view/FF9673081062A7A446331644FB137FE2/S0924933822021162a.pdf/div-class-title-personalized-care-in-opioid-use-disorder-maintained-on-buprenorphine-div.pdf","host_type":"journal"},{"url":"https://www.cambridge.org/core/services/aop-cambridge-core/content/view/FF9673081062A7A446331644FB137FE2/S0924933822021162a.pdf/div-class-title-personalized-care-in-opioid-use-disorder-maintained-on-buprenorphine-div.pdf","host_type":"publisher"},{"url":"https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0924933822021162","host_type":"publisher"},{"url":"https://doi.org/10.1192/j.eurpsy.2022.2116","host_type":"journal"},{"url":"https://doaj.org/article/9090078dd0bb4047a0f66dc7e8542fe0","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/9567902","host_type":"repository"}],"fields_of_study":["Opioid Use Disorder Treatment","Attention Deficit Hyperactivity Disorder","Pharmaceutical Practices and Patient Outcomes"],"mesh_terms":[],"keywords":["Buprenorphine","Abstinence","Medicine","Opioid use disorder","Opioid","Polysubstance dependence","Contingency management","Opiate Substitution Treatment","Retention rate","Anesthesia","Substance abuse","Psychiatry","Internal medicine"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T00:31:12.755732Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}