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START Study Retention: Perspectives of Suboxone Dropouts.

Poster presented at the College on Problems of Drug Dependence (CPDD) annual meeting, Scottsdale, AZ, June 12-17, 2010.

Cheryl Teruya, PhD, Christie Thomas, MPH, Anya Rosensteel, Albert Hasson, MSW, Maureen Hillhouse, PhD, Yih-Ing Hser, PhD, Walter Ling, MD (all from Integrated Substance Abuse Programs, UCLA, PR Node).

Retention has long been linked to treatment outcome, with those who remain in treatment longer experiencing more favorable treatment results. A recent CTN study, Starting Treatment with Agonist Replacement Therapies (START), CTN-0027, randomly assigned treatment-seeking opioid-dependent individuals to either methadone or Suboxone (buprenorphine plus naloxone) for 24 weeks of pharmacotherapy. It was estimated that 60% of participants would complete the trial; however, within the first year of the study, a pattern emerged that remained relatively stable over the course of the trial. A disproportionately larger number of the Suboxone group, compared to the methadone group, discontinued study participation prematurely, with many dropping out shortly after enrollment (57% Suboxone vs. 27% methadone). This study explored the nature of the different retention rates from the perspective of the patients and providers. Examination of one-hour, in-depth semistructured face-to-face interviews with staff and patients identified potential barriers and facilitators to treatment retention, including medication-related factors (e.g., dosing), patient factors (e.g., prior treatment, medication preferences, expectations), and life events (e.g., incarceration). Recommendations offered by patients (e.g., provision of take-home medications) may help in efforts to improve treatment retention. Ultimately, findings from this study may inform clinical practice, resulting in improved utilization and integration of buprenorphine within opioid treatment programs. (Presentation, PDF, English, 2010)

Keywords: Buprenorphine/Naloxone | Community health services | CTN platform/ancillary study | Methadone maintenance | Opioid dependence | Pharmacological therapy | Retention - Research | Suboxone | College on Problems of Drug Dependence (CPDD) annual meeting, 2010

Document No: 504

Submitted by Christie Thomas, MPH, PR Node, 6/29/2010.

Hasson, Albert search mail
Hillhouse, Maureen search mail
Hser, Yih-Ing search mail
Ling, Walter search mail
Rosensteel, Anya search
Teruya, Cheryl search
Thomas, Christie search mail
NIDA-CTN-0027 search www
Pacific Region (Lead) search www
Delaware Valley search www
New England Consortium (formerly New England) search www
Pacific Northwest search www
Western States (formerly California/Arizona and Oregon/Hawaii) search www

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Updated 6/2010 --