Article Figures & Data
Figures
- Figure 1.
Survival curve of dropout for patients receiving buprenorphine separated by high, medium, and low continuity of care (n = 232) between January 2015 and December 2018. Note. To further understand the impact of continuity of care on retention, survival curves were plotted for patients at high (1 standard deviation above the mean), medium (at the mean), and low (1 standard deviation below the mean) continuity of care.
Tables
- Table 1.
Demographic and Clinical Characteristics of Patients Receiving Buprenorphine in a Family Medicine Residency Clinic (n = 238) between January 2015 and December 2017
Variable n [%] Age, years, mean (SD) 35.5 (11.0) Female 98 [41] Marital status n = 235 Single, never married 188 [80] Married 38 [16] Divorced, separated, or widowed 9 [4] Race Black 46 [19] White 168 [71] Other 24 [10] Insurance coverage Medicaid 139 [58] Other insurance 80 [34] Self-pay/uninsured 19 [8] Comorbid conditions ADHD 27 [11] Anxiety 101 [42] Bipolar 14 [6] Chronic pain 34 [14] Depression 82 [34] Personality disorder 10 [4] Psychosis 6 [3] PTSD 19 [8] Medications ADHD/stimulants 18 [8] Antipsychotics 36 [15] Benzodiazepines 6 [3] Mood stabilizers 15 [6] SSRI/SNRI 92 [39] Other antidepressants 41 [17] Smoking status n = 236 Current smoker 175 [74] Former smoker 30 [13] Never smoker 31 [13] Number of PCP visits, mean (SD) 20.3 (16.8) Number of buprenorphine visits, mean (SD) 15.6 (13.6) Number of different PCPs seen, mean (SD) 7.0 (5.3) Continuity of care (K index) 0.64 (0.21) Seen by behavioral health 47 [20] ADHD, attention deficit hyperactivity disorder; PCP, primary care provider; PTSD, posttraumatic stress disorder; SNRI, selective norepinephrine reuptake inhibitor; SSRI, selective serotonin reuptake inhibitor; SD, standard deviation.
- Table 2.
Demographic and Clinical Characteristics of Patients Receiving Buprenorphine (January 2015 to December 2017) Related to Retention in December 2018 (n = 238)
Variable Retained N = 82 n [%] Dropped N = 156 n [%] χ2 ort P Age, years, mean (SD) 37.4 (11.5) 34.4 (10.6) −1.98 .049 Female 40 [49] 58 [37] 2.99 .08 Marital status .66 Single, never married 63 [78] 125 [81] Married 14 [17] 24 [16] Divorced, separated, or widowed 4 [5] 5 [3] Race 5.60 .06 Black 9 [11] 37 [24] White 64 [78] 104 [67] Other 9 [11] 15 [10] Insurance coverage <.001 Medicaid 51 [62] 88 [56] Other insurance 31 [38] 49 [32] Self-pay/uninsured 0 [0] 19 [12] Comorbid conditions ADHD 11 [13] 16 [10] 0.55 .47 Anxiety 42 [51] 59 [38] 3.95 .047 Bipolar 6 [7] 8 [5] 0.47 .50 Chronic pain 17 [21] 17 [11] 4.25 .039 Depression 31 [38] 51 [33] 0.62 .43 Personality disorder 5 [6] 5 [3] 1.12 .29 Psychosis 3 [4] 3 [2] .42 PTSD 6 [7] 13 [8] 0.08 .78 Medications ADHD/Stimulants 8 [10] 10 [6] 0.86 .35 Antipsychotics 12 [15] 23 [15] 0.00 .98 Benzodiazepines 2 [2] 4 [3] 1.00 Mood stabilizers 6 [7] 9 [6] 0.21 .64 SSRI/SNRI 28 [34] 64 [41] 1.07 .30 Other antidepressants 17 [21] 24 [15] 1.08 .30 Smoking status (n = 237) 11.40 .003 Current smoker 50 [60] 125 [81] Former smoker 16 [20] 14 [9] Never smoker 16 [20] 15 [10] Continuity of care, mean (SD) 0.70 (0.12) 0.61 (0.24) −3.87 <.001 Seen by behavioral health 23 [28] 24 [15] 5.44 .019 Buprenorphine status at first visit 2.16 .34 New induction 17 [21] 38 [24] Restart 11 [13] 30 [19] Continuation 54 [66] 88 [57] ADHD, attention deficit hyperactivity disorder; PTSD, posttraumatic stress disorder; SSRI, selective serotonin reuptake inhibitor; SNRI, selective norepinephrine reuptake inhibitor; SD, standard deviation.
Independent samples t-test were used to examine differences in continuous variables (signified by mean, SD) by retention status; χ2 tests were used to examine differences in categorical variables by retention status. The retained category includes 6 patients who died during the study observation period and are censored in the survival analysis. For variables with cells < 5, a Fisher’s exact test was used to calculate the P-value (marital status, insurance type, benzodiazepine prescription, and psychosis). For tables larger than 2 × 2, SAS uses a Monte Carlo simulation to estimate the P-value in Fisher’s exact tests.
- Table 3.
Cox Proportional Hazards Model with Demographic and Clinical Characteristics of Patients Receiving Buprenorphine Predicting Time in Treatment (n = 231) between January 2015 and December 2018
Variable HR 95% CI Age 0.98 [0.97, 1.00] Gender 0.75 [0.51, 1.09] Race White REF Black 1.54 [0.99, 2.41] Other 1.17 [0.64, 2.12] Insurance status Medicaid REF Other insurance 1.39 [0.94, 2.05] Self-pay/uninsured 3.32 [1.86, 5.92] Anxiety 0.86 [0.60, 1.22] Chronic pain 1.18 [0.69, 2.02] Smoking status Current smoker REF Former smoker 0.59 [0.32, 1.07] Never smoker 0.65 [0.37, 1.13] Continuity of care 0.61 [0.51, 0.74] Seen by behavioral health 0.63 [0.40, 1.00] HR, hazard ratio; CI, confidence interval; REF, reference.
Bold values are statistically significant at P < .05.
