SOCIAL AND STRUCTURAL DETERMINANTS OF BUPRENORPHINE ADHERENCE AMONG INDIVIDUALS WITH OPIOID USE DISORDER
Author(s)
Rana Zalmai, PharmD1, Carolyn Brown, PhD1, Tyler Jordan Varisco, PharmD, PhD1, Tiffany Whittaker, PhD2, Anton Avanceña, PhD1, Leticia Rae Moczygemba, PharmD, PhD1.
1College of Pharmacy, The University of Texas at Austin, Austin, TX, USA, 2Department of Educational Psychology, The University of Texas at Austin, Austin, TX, USA.
1College of Pharmacy, The University of Texas at Austin, Austin, TX, USA, 2Department of Educational Psychology, The University of Texas at Austin, Austin, TX, USA.
OBJECTIVES: To describe predisposing, enabling, and need factors among individuals prescribed buprenorphine for opioid use disorder (OUD) and examine bivariate associations with buprenorphine adherence.
METHODS: Cross-sectional survey of individuals prescribed buprenorphine for OUD using a national online panel. Measures included buprenorphine dose and adherence, predisposing factors (education, employment, annual income, housing instability, and criminal justice involvement), enabling factors (insurance, stigma, social support, economic and travel burden), need factors (perceived need for OUD treatment, heavy alcohol use, and mental health comorbidities), and demographics. Descriptive statistics summarized all variables. Bivariate associations were examined using appropriate statistical tests.
RESULTS: Among 200 participants who were predominantly white (78.5%), non-Hispanic (85.5%), men (69.5%) with mean age of 35.12 (±11.99) years, 18% reported high school education or lower, 47.5% reported unemployment, and 43.5% reported an annual household income between $20,000 and < $35,000. Mean 30-day adherence score was 79.03 out of 100 (±13.27), and 50% reported buprenorphine doses between 8-15 mg. Employment status was significantly associated with adherence; participants not in the labor force (student, homemaker, retired) had significantly lower mean adherence compared to employed participants (mean difference=-7.80, p=0.020). Participants with recent incarceration had significantly lower mean adherence than those without criminal justice involvement (mean difference=-12.80, p=0.0002). Social support was positively correlated with adherence (r=0.15, p=0.031). Opioid stigma agreement (r=-0.17, p=0.015) and harm (r=-0.18, p=0.011) were negatively correlated with adherence. Travel burden including distance to clinic (ρ=-0.25, p=0.0004), transportation (ρ=-0.15, p=0.036), and travel time (ρ=-0.26, p=0.0002) were negatively correlated with adherence. Self-rated health was positively correlated with adherence (ρ=0.494, p<0.0001), while heavy alcohol use (4+/5+ drinks on one occasion in the past year) was associated with lower adherence (mean difference=-9.08, p<0.0001).
CONCLUSIONS: Multiple predisposing, enabling and need characteristics were associated with buprenorphine adherence. Clinicians should assess, and respond to, social drivers of health when evaluating treatment for OUD.
METHODS: Cross-sectional survey of individuals prescribed buprenorphine for OUD using a national online panel. Measures included buprenorphine dose and adherence, predisposing factors (education, employment, annual income, housing instability, and criminal justice involvement), enabling factors (insurance, stigma, social support, economic and travel burden), need factors (perceived need for OUD treatment, heavy alcohol use, and mental health comorbidities), and demographics. Descriptive statistics summarized all variables. Bivariate associations were examined using appropriate statistical tests.
RESULTS: Among 200 participants who were predominantly white (78.5%), non-Hispanic (85.5%), men (69.5%) with mean age of 35.12 (±11.99) years, 18% reported high school education or lower, 47.5% reported unemployment, and 43.5% reported an annual household income between $20,000 and < $35,000. Mean 30-day adherence score was 79.03 out of 100 (±13.27), and 50% reported buprenorphine doses between 8-15 mg. Employment status was significantly associated with adherence; participants not in the labor force (student, homemaker, retired) had significantly lower mean adherence compared to employed participants (mean difference=-7.80, p=0.020). Participants with recent incarceration had significantly lower mean adherence than those without criminal justice involvement (mean difference=-12.80, p=0.0002). Social support was positively correlated with adherence (r=0.15, p=0.031). Opioid stigma agreement (r=-0.17, p=0.015) and harm (r=-0.18, p=0.011) were negatively correlated with adherence. Travel burden including distance to clinic (ρ=-0.25, p=0.0004), transportation (ρ=-0.15, p=0.036), and travel time (ρ=-0.26, p=0.0002) were negatively correlated with adherence. Self-rated health was positively correlated with adherence (ρ=0.494, p<0.0001), while heavy alcohol use (4+/5+ drinks on one occasion in the past year) was associated with lower adherence (mean difference=-9.08, p<0.0001).
CONCLUSIONS: Multiple predisposing, enabling and need characteristics were associated with buprenorphine adherence. Clinicians should assess, and respond to, social drivers of health when evaluating treatment for OUD.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR173
Topic
Patient-Centered Research
Topic Subcategory
Adherence, Persistence, & Compliance
Disease
No Additional Disease & Conditions/Specialized Treatment Areas