TY  - JOUR
PY  - 2016//
TI  - Factors associated with non-adherence to Buprenorphine-naloxone among opioid dependent African-Americans: a retrospective chart review
JO  - American journal on addictions
A1  - Kumari, Suneeta
A1  - Manalai, Partam
A1  - Leong, Sharlene
A1  - Wooditch, Alese
A1  - Malik, Mansoor
A1  - Lawson, William B.
SP  - 110
EP  - 117
VL  - 25
IS  - 2
N2  - Background and Objectives    Opioid use disorders are common, chronic relapsing disorders. Buprenorphine (BUP) is an FDA approved medication in the treatment of opioid use disorders, but patient adherence to this medication remains a challenge. To identify risk factors for non-adherence, this chart review study examined the association between DSM-IV Axis I psychiatric disorders, substance use, demographics, and adherence to BUP-naloxone in African-American patients.       Methods    Charts were selected of patients who had ≥5 visits and completed psychometric screens (Patient Health Questionnaire, Mood Disorder Questionnaire, and a posttraumatic stress disorder questionnaire) at the time of the initial visit (N = 50). Urine drug screens (UDS) were also obtained. Treatment adherence was defined as BUP presence in UDS for ≥80% of the visits.       Results    A total of 48% of patients were adherent to treatment. Non-adherent patients had higher rates of use for not only opioids, but also cocaine, and alcohol. Cocaine use was associated with BUP-naloxone non-adherence even after controlling for opioid use. Attendance in cognitive behavioral group therapy sessions (CBT) was significantly associated with adherence. Patients endorsing PTSD symptoms showed higher adherence to treatment compared to those who did not endorse these symptoms.       Conclusions and Scientific Significance    Our results indicate that alcohol and illicit substance use is associated with non-adherence to BUP-naloxone treatment, and suggests that CBT and efforts to promote abstinence from non-opioid substance use may improve adherence among African-Americans. These findings contribute to growing literature on understanding adherence to BUP-naloxone, which is critical to reduce morbidity and mortality. (Am J Addict 2016;25:110-117)<p />  <p>Language: en</p>
LA  - en
SN  - 1055-0496
UR  - http://dx.doi.org/10.1111/ajad.12325
ID  - ref1
ER  -