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Abstract：
Although treatment of opioid use disorders (OUD) with medications is expanding, the extent to which practitioners are prescribing medications following best practices has received little attention.
The aim of this study was to determine the extent to which privately insured patients being treated for OUD with buprenorphine were treated in a manner consistent with practice guidelines.
Longitudinal analyses of a large commercial claims dataset from 2012 to 2016.
We analyzed data for 38,517 patients with an OUD diagnosis continuously enrolled for 3 months prior to and 6 months after an initial buprenorphine or buprenorphine-naloxone prescription fill.
We evaluated whether practitioners tested patients for hepatitis B, hepatitis C, HIV, and liver function; how often they received urine drug screens; the frequency of outpatient visits; and the extent to which they filled prescriptions for buprenorphine for at least 6 months.
Practitioners tested approximately 4.7% of patients for hepatitis B, 6.5% for hepatitis C, and 29.3% for HIV; they tested 8.0% for liver functioning; and gave 33.3% urine drug tests. Approximately 76% of patients had at least one outpatient visit for their OUD. Among those with at least one visit, the mean number of visits was 7.38. After the initial prescription, 47.5% stayed on buprenorphine for at least 6 months.
A large portion of privately insured patients receiving buprenorphine for OUD did not receive care consistent with guidelines.
The aim of this study was to determine the extent to which privately insured patients being treated for OUD with buprenorphine were treated in a manner consistent with practice guidelines.
Longitudinal analyses of a large commercial claims dataset from 2012 to 2016.
We analyzed data for 38,517 patients with an OUD diagnosis continuously enrolled for 3 months prior to and 6 months after an initial buprenorphine or buprenorphine-naloxone prescription fill.
We evaluated whether practitioners tested patients for hepatitis B, hepatitis C, HIV, and liver function; how often they received urine drug screens; the frequency of outpatient visits; and the extent to which they filled prescriptions for buprenorphine for at least 6 months.
Practitioners tested approximately 4.7% of patients for hepatitis B, 6.5% for hepatitis C, and 29.3% for HIV; they tested 8.0% for liver functioning; and gave 33.3% urine drug tests. Approximately 76% of patients had at least one outpatient visit for their OUD. Among those with at least one visit, the mean number of visits was 7.38. After the initial prescription, 47.5% stayed on buprenorphine for at least 6 months.
A large portion of privately insured patients receiving buprenorphine for OUD did not receive care consistent with guidelines.
摘要：
尽管用药物治疗阿片类药物使用障碍（OUD）正在扩大，医生在多大程度上遵循最佳实践开药，但很少受到关注。
这项研究的目的是确定接受丁丙诺啡治疗的私人保险患者以符合实践指南的方式治疗OUD的程度。
2012年至2016年大型商业索赔数据集的纵向分析。
我们分析了38,517名诊断为OUD的患者在初次服用丁丙诺啡或丁丙诺啡-纳洛酮处方补药前3个月和后6个月的数据。
我们评估了从业人员是否对患者进行了乙型肝炎检测，丙型肝炎,艾滋病毒,和肝功能；他们多久接受一次尿液药物筛查；门诊就诊的频率；以及他们在至少6个月内服用丁丙诺啡处方的程度。
从业者对大约4.7%的患者进行了乙型肝炎检测，丙型肝炎为6.5%，和29.3％的艾滋病毒；他们测试了8.0％的肝功能；并进行了33.3％的尿液药物测试。大约76％的患者至少有一次OUD门诊。在那些至少有一次访问的人中，平均访问次数为7.38。在最初的处方之后，47.5％的人服用丁丙诺啡至少6个月。
大部分接受丁丙诺啡治疗OUD的私人保险患者没有接受与指南一致的护理。
这项研究的目的是确定接受丁丙诺啡治疗的私人保险患者以符合实践指南的方式治疗OUD的程度。
2012年至2016年大型商业索赔数据集的纵向分析。
我们分析了38,517名诊断为OUD的患者在初次服用丁丙诺啡或丁丙诺啡-纳洛酮处方补药前3个月和后6个月的数据。
我们评估了从业人员是否对患者进行了乙型肝炎检测，丙型肝炎,艾滋病毒,和肝功能；他们多久接受一次尿液药物筛查；门诊就诊的频率；以及他们在至少6个月内服用丁丙诺啡处方的程度。
从业者对大约4.7%的患者进行了乙型肝炎检测，丙型肝炎为6.5%，和29.3％的艾滋病毒；他们测试了8.0％的肝功能；并进行了33.3％的尿液药物测试。大约76％的患者至少有一次OUD门诊。在那些至少有一次访问的人中，平均访问次数为7.38。在最初的处方之后，47.5％的人服用丁丙诺啡至少6个月。
大部分接受丁丙诺啡治疗OUD的私人保险患者没有接受与指南一致的护理。
