Abstract

Objectives

To describe the use of buprenorphine/naloxone micro-inductions in hospitalized patients and characterize the success rate of these inductions.

Methods

We conducted a retrospective chart review of hospitalized patients receiving a buprenorphine/naloxone micro-induction for opioid use disorder in a tertiary care hospital from Jan 2020–Dec 2020. The primary outcome was a description of the micro-induction prescribing patterns used. The secondary outcomes were a description of the demographic characteristics of patients, the estimated frequency of withdrawal symptoms experienced by patients undergoing a micro-induction, and the overall success rate of the micro-inductions defined as retention on buprenorphine/naloxone therapy with no precipitated withdrawal experienced.

Results

Thirty-three patients were included in the analysis. Three main micro-induction regimens were identified, including rapid micro-inductions (8 patients), 0.5 mg SL BID initiations (6 patients), and 0.5 mg SL daily initiations (19 patients). Twenty-four patients (73%) met the criteria for a successful micro-induction, defined as being retained in buprenorphine/naloxone therapy with no precipitated withdrawal experienced. The most common reason for micro-induction failure was patient request to discontinue buprenorphine/naloxone therapy due to perceived adverse effects or personal preference.

Conclusion

Buprenorphine/naloxone micro-induction in hospitalized patients resulted in a majority of patients being successfully initiated on buprenorphine/naloxone therapy without requiring opioid abstinence prior to induction. Dosing regimens were variable, and the ideal regimen remains unclear.

中文翻译：

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三级医院丁丙诺啡/纳洛酮微诱导：回顾性队列分析

摘要

目标

描述丁丙诺啡/纳洛酮微诱导在住院患者中的使用并描述这些诱导的成功率。

方法

我们对 2020 年 1 月至 2020 年 12 月在一家三级护理医院接受丁丙诺啡/纳洛酮微诱导治疗阿片类药物使用障碍的住院患者进行了回顾性图表审查。主要结果是对所使用的微诱导处方模式的描述。次要结局是对患者人口统计特征的描述、接受微诱导的患者经历戒断症状的估计频率以及定义为保留丁丙诺啡/纳洛酮治疗且无突然戒断的微诱导的总体成功率有经验的。

结果

分析中包括 33 名患者。确定了三种主要的微诱导方案，包括快速微诱导（8 名患者）、0.5 mg SL BID 起始（6 名患者）和 0.5 mg SL 每日起始（19 名患者）。24 名患者 (73%) 符合成功微诱导的标准，定义为保留丁丙诺啡/纳洛酮治疗且未经历突然停药。微诱导失败的最常见原因是患者由于感知到的不良反应或个人偏好而要求停止丁丙诺啡/纳洛酮治疗。

结论

对住院患者进行丁丙诺啡/纳洛酮微诱导后，大多数患者成功开始丁丙诺啡/纳洛酮治疗，无需在诱导前戒除阿片类药物。给药方案各不相同，理想的方案仍不清楚。