The impact of mental health comorbidities on adherence to buprenorphine: A claims based analysis

Megan Litz, Douglas Leslie

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and Objectives: Previous research has been inconclusive about whether opioid-dependent patients with psychiatric comorbidities have shorter treatment retention and higher relapse rates. This study aims to evaluate the impact of mental health comorbidities on adherence to buprenorphine using a large, national health insurance claims data base. Methods: We used MarketScan® data from 2012 to 2014 to perform this analysis. Inclusion criteria included all patients with an opioid use disorder-related ICD-9 code who had been prescribed buprenorphine (n = 2947). Medication adherence was defined using the Medication Possession Ratio ≥.8 (MPR) and logistic regression was used to examine the association between medication adherence and mental health diagnoses, which included Alzheimer's/dementia, schizophrenia, other psychosis, major depressive disorder/bipolar disorder (MDDBP), anxiety disorder, personality disorder, and mental health disorder not elsewhere specified (NOS). Results: Of the 2947 patients included in our analysis, the most common diagnoses were anxiety disorder: n = 648 (22.0%), MDDBP: n = 467 (15.9%), and mental health disorder NOS: n = 959 (32.5%). Patients diagnosed with MDDBP were significantly less likely to adhere to opioid pharmacotherapy (OR =.805, 95%CI =.651,.994) than patients without MDDBP. Conclusions and Scientific Significance: The presence of a psychiatric comorbidity can significantly affect adherence to buprenorphine. These trends illustrate the need for clinicians treating opioid use disorder with buprenorphine to screen for psychiatric disorders and monitor their medication adherence. There may also be opportunities to design interventions to help this vulnerable population adhere to buprenorphine and other forms of opioid pharmacotherapy. (Am J Addict 2017;26:859–863).

Original languageEnglish (US)
Pages (from-to)859-863
Number of pages5
JournalAmerican Journal on Addictions
Volume26
Issue number8
DOIs
StatePublished - Dec 1 2017

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Insurance Claim Review
Buprenorphine
Major Depressive Disorder
Comorbidity
Mental Health
Bipolar Disorder
Opioid Analgesics
Medication Adherence
Psychiatry
International Classification of Diseases
Anxiety Disorders
Mental Disorders
Opioid-Related Disorders
Drug Therapy
Personality Disorders
National Health Programs
Vulnerable Populations
Psychotic Disorders
Schizophrenia
Alzheimer Disease

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

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title = "The impact of mental health comorbidities on adherence to buprenorphine: A claims based analysis",
abstract = "Background and Objectives: Previous research has been inconclusive about whether opioid-dependent patients with psychiatric comorbidities have shorter treatment retention and higher relapse rates. This study aims to evaluate the impact of mental health comorbidities on adherence to buprenorphine using a large, national health insurance claims data base. Methods: We used MarketScan{\circledR} data from 2012 to 2014 to perform this analysis. Inclusion criteria included all patients with an opioid use disorder-related ICD-9 code who had been prescribed buprenorphine (n = 2947). Medication adherence was defined using the Medication Possession Ratio ≥.8 (MPR) and logistic regression was used to examine the association between medication adherence and mental health diagnoses, which included Alzheimer's/dementia, schizophrenia, other psychosis, major depressive disorder/bipolar disorder (MDDBP), anxiety disorder, personality disorder, and mental health disorder not elsewhere specified (NOS). Results: Of the 2947 patients included in our analysis, the most common diagnoses were anxiety disorder: n = 648 (22.0{\%}), MDDBP: n = 467 (15.9{\%}), and mental health disorder NOS: n = 959 (32.5{\%}). Patients diagnosed with MDDBP were significantly less likely to adhere to opioid pharmacotherapy (OR =.805, 95{\%}CI =.651,.994) than patients without MDDBP. Conclusions and Scientific Significance: The presence of a psychiatric comorbidity can significantly affect adherence to buprenorphine. These trends illustrate the need for clinicians treating opioid use disorder with buprenorphine to screen for psychiatric disorders and monitor their medication adherence. There may also be opportunities to design interventions to help this vulnerable population adhere to buprenorphine and other forms of opioid pharmacotherapy. (Am J Addict 2017;26:859–863).",
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The impact of mental health comorbidities on adherence to buprenorphine : A claims based analysis. / Litz, Megan; Leslie, Douglas.

In: American Journal on Addictions, Vol. 26, No. 8, 01.12.2017, p. 859-863.

Research output: Contribution to journalArticle

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AB - Background and Objectives: Previous research has been inconclusive about whether opioid-dependent patients with psychiatric comorbidities have shorter treatment retention and higher relapse rates. This study aims to evaluate the impact of mental health comorbidities on adherence to buprenorphine using a large, national health insurance claims data base. Methods: We used MarketScan® data from 2012 to 2014 to perform this analysis. Inclusion criteria included all patients with an opioid use disorder-related ICD-9 code who had been prescribed buprenorphine (n = 2947). Medication adherence was defined using the Medication Possession Ratio ≥.8 (MPR) and logistic regression was used to examine the association between medication adherence and mental health diagnoses, which included Alzheimer's/dementia, schizophrenia, other psychosis, major depressive disorder/bipolar disorder (MDDBP), anxiety disorder, personality disorder, and mental health disorder not elsewhere specified (NOS). Results: Of the 2947 patients included in our analysis, the most common diagnoses were anxiety disorder: n = 648 (22.0%), MDDBP: n = 467 (15.9%), and mental health disorder NOS: n = 959 (32.5%). Patients diagnosed with MDDBP were significantly less likely to adhere to opioid pharmacotherapy (OR =.805, 95%CI =.651,.994) than patients without MDDBP. Conclusions and Scientific Significance: The presence of a psychiatric comorbidity can significantly affect adherence to buprenorphine. These trends illustrate the need for clinicians treating opioid use disorder with buprenorphine to screen for psychiatric disorders and monitor their medication adherence. There may also be opportunities to design interventions to help this vulnerable population adhere to buprenorphine and other forms of opioid pharmacotherapy. (Am J Addict 2017;26:859–863).

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