Cited by 76Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesHealthcare Policy and Management

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Patterns and Quality of Buprenorphine Opioid Agonist Treatment in a Large Medicaid Program

Gordon, Adam J., Lo-Ciganic, Wei-Hsuan, Cochran, Gerald, Gellad, Walid F., Cathers, Terri, Kelley, David, Donohue, Julie M.·2015·Journal of Addiction Medicine

DOI 10.1097/adm.0000000000000164

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Abstract

OBJECTIVES: Use of buprenorphine - an effective treatment for opioid use disorders (OUDs) - has increased rapidly in recent years and is often financed by Medicaid. We investigated predictors of buprenorphine treatment, patterns of care, and quality of care in a large state Medicaid program. METHODS: Data from Pennsylvania Medicaid from 2007 to 2012 provided information regarding diagnoses, demographic characteristics, enrollment, and use of inpatient and outpatient services, and prescription drugs. We identified adult enrollees using buprenorphine, and examined prevalence of OUD diagnosis and patterns of use (duration and dose) and quality of care (physician visits, receipt of behavioral health counseling, urine drug screens, and other prescription drug use). We use a mixed logistic regression model to examine enrollee characteristics associated with buprenorphine use. RESULTS: The share of enrollees with OUD filling prescriptions for buprenorphine increased from 2985 (9.8%) to 12,691 (25.2%) from 2007 to 2012. Between 26.2 and 32.0% of enrollees using buprenorphine had no diagnosis of OUD, depending on the year. Only 60.1% of enrollees with buprenorphine use received at least one urine drug screen, 41.0% had behavioral health counseling services, and 34.7 and 38.0% had other opioid and benzodiazepine claims, respectively, concomitant with buprenorphine use. Quality of care was lower among those with no OUD diagnosis recorded. The mean daily doses of buprenorphine decreased over time. We found wide variation in likelihood of buprenorphine use among those with OUD based upon age, sex, and race. CONCLUSIONS: Increases in buprenorphine treatment in a Medicaid population were observed across time; however, increases varied by age, sex, and rate, and the quality of care received seemed to be generally poor. The quality of the provision of buprenorphine treatment occurring in Medicaid populations should be further explored.

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Authors: Gordon, A. J., Lo-Ciganic, W.-H., Cochran, G., Gellad, W. F., Cathers, T., Kelley, D., & Donohue, J. M.
Affiliations: University of Arizona (US)
VA Pittsburgh Healthcare System (US)
University of Pittsburgh (US)
Pennsylvania Department of Human Services (US)
Corresponding author: Gordon, Adam J.
ORCID: Gordon, Adam J.
Cochran, Gerald
Gellad, Walid F.
Donohue, Julie M.
Venue: Journal of Addiction Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2015-11
Volume: 9
Issue: 6
Pages: 470-477
ISSN: 1932-0620 (ISSN-L)
DOI: 10.1097/adm.0000000000000164
OpenAlex: W1891063291
Cited by: 76
References: 35
Citations by year: 2026: 3 · 2025: 1 · 2024: 8 · 2023: 7 · 2022: 5 · 2021: 15 · 2020: 10 · 2019: 11 · 2018: 8 · 2017: 4 · 2016: 2 · 2015: 2
FWCI: 5.72
Type: journal article
Language: en
Open access: closed
Locations: Journal of Addiction Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs
Pennsylvania Department of Human Services
Centers for Disease Control and Prevention (U01CE002496)
VA Pittsburgh Healthcare System
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Keywords: buprenorphine, opioid use disorder, Medicaid, quality of care, patterns of care, urine drug testing, benzodiazepine use, prescription drug use, racial disparities, sex disparities, age disparities
MeSH terms: Adolescent, Adult, Analgesics, Opioid, Buprenorphine, Female, Humans, Male, Medicaid, Middle Aged, Opioid-Related Disorders, Quality of Health Care, United States, Logistic Models, Prescription Drugs, Young Adult

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Patterns and Quality of Buprenorphine Opioid Agonist Treatment in a Large Medicaid Program

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