Article Figures & Data
Tables
- Table 1
Characteristics of Outpatients Initiating Buprenorphine Treatment for Opioid Use Disorders, Overall and According to Vital Status
Characteristic Overall (N=713) Vital Status Alive (n=684) Deceased (n=29) P Value Sex, No. (%) .16 Male 535 (75.0) 510 (74.6) 25 (86.2) Female 178 (25.0) 174 (25.4) 4 (13.8) Age at first buprenorphine claim, mean (SD), y 32.9 (9.0) 32.6 (8.9) 41.0 (9.2) <.001 Status of beneficiary related to health .21 insurance affiliation, No. (%) Insured 678 (95.1) 649 (94.9) 29 (100.0) Relative 35 (4.9) 35 (5.1) 0 (0.0) Universal insurance coverage, No. (%) 296 (41.5) 284 (41.5) 12 (41.4) .99 Specialty of first buprenorphine prescriber, No. (%) 1.00 General practitioner 683 (95.8) 654 (95.6) 29 (100.0) Psychiatrist 10 (1.4) 10 (1.5) 0 (0.0) Other specialist 9 (1.3) 9 (1.3) 0 (0.0) Not determined 11 (1.5) 11 (1.6) 0 (0.0) Practice of first buprenorphine prescriber, No. (%) .69 Private practice 604 (84.7) 579 (84.6) 25 (86.2) Salaried in a private establishment 92 (12.9) 88 (12.9) 4 (13.8) Not determined 17 (2.4) 17 (2.5) 0 (0.0) Deprivation index (FDep08a), mean (SD) 0.4 (1.6) 0.4 (1.6) 0.1 (1.5) .41 Charlson comorbidity index,b No. (%) .006 0 606 (85.0) 587 (85.8) 19 (65.5) 1 85 (11.9) 78 (11.4) 7 (24.1) ≥2 22 (3.1) 19 (2.8) 3 (10.3) Health insurance coverage for a psychiatric disorder, No. (%) 55 (7.7) 51 (7.5) 4 (13.8) .21 Hospitalization, No. (%) For a psychiatric disorder 25 (3.5) 23 (3.4) 2 (6.9) .31 For another disorder 106 (14.9) 100 (14.6) 6 (20.7) .37 Use of opioid analgesics, No. (%) 429 (60.2) 417 (61.0) 12 (41.4) .04 Morphine 39 (5.5) 36 (5.3) 3 (10.3) .21 Codeine, combinations 212 (29.7) 207 (30.3) 5 (17.2) .13 Dextropropoxyphene, combinations 133 (18.7) 127 (18.6) 6 (20.7) .77 Tramadol 134 (18.8) 129 (18.9) 5 (17.2) .83 Tramadol, combinations 227 (31.8) 221 (32.3) 6 (20.7) .19 Use of other medications, No. (%) Benzodiazepines and similar 538 (75.5) 512 (74.9) 26 (89.7) .08 Antidepressants 304 (42.6) 286 (41.8) 18 (62.1) .03 Antipsychotics 216 (30.3) 206 (30.1) 10 (34.5) .62 Antiepileptics 107 (15.0) 100 (14.6) 7 (24.1) .18 Drugs for alcohol dependence 72 (10.1) 69 (10.1) 3 (10.3) .96 - Table 2
Factors Associated With Mortality Among Outpatients With Opioid Use Disorder Treated With Buprenorphine, in Univariate and Multivariate Cox Models
Factor Crude Hazard Ratio (95% CI) P Value Adjusted Hazard Ratio (95% CI) P Value Buprenorphine treatment: out vs in 33.22 (11.56–95.50) <.001 29.04 (10.04–83.99) <.001 Age, y <30 Ref Ref 30–40 1.37 (0.42–4.48) .61 1.08 (0.33–3.54) .90 >40 6.47 (2.40–17.43) <.001 3.94 (1.45–10.69) .007 Charlson comorbidity index 0 Ref – – 1 2.68 (1.23–6.37) .03 ≥2 4.75 (1.41–16.08) .01 Sex: female vs male 0.49 (0.17–1.41) .18 – – Medication use Opioid analgesics 0.40 (0.19–0.83) .01 0.37 (0.18–0.79) .01 Antidepressants 2.06 (0.97–4.37) .06 – – Benzodiazepines (and similar) 2.61 (0.79–8.62) .12 – – Ref=reference group.
Additional Files
Supplemental Appendix
Supplemental Appendix
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The Article in Brief
Mortality Associated With Time in and Out of Buprenorphine Treatment in French Office-Based General Practice: A 7-year Cohort Study
Julie Dupouy , and colleagues
Background This study investigates mortality in outpatients in France with opioid use disorder treated by buprenorphine, focusing on periods in and out of buprenorphine treatment.
What This Study Found Buprenorphine reduces mortality for those with opioid use disorder, but periods off treatment are associated with much higher mortality rates. The mortality rate for study subjects was 0.63/100 person-year, compared to 0.24/100 person-year for other individuals of the same age range during the same time period.
Implications
- The authors encourage physicians to avoid interruption of treatment and encourage patients to remain in treatment for a sufficient amount of time.