RTI Study Finds Low Rates of Compliance with Buprenorphine Prescribing Guidelines for Treating Individuals with an Opioid Use Disorder

Lack of compliance is a missed opportunity to maximize the benefits of opioid use disorder treatment

RESEARCH TRIANGLE PARK, N.C. – RTI experts recently published a study measuring the extent to which providers follow recommended treatment guidelines when prescribing buprenorphine for opioid use disorder (OUD). The study, led by Tami Mark, PhD, and RTI experts, analyzed data from 38,517 commercially-insured patients with an OUD diagnosis who received buprenorphine treatment for their OUD. They found a large portion of patients did not receive care consistent with treatment guidelines recommended by the American Society of Addiction Medicine:

• Guidelines recommend testing all patients who receive buprenorphine for Hepatis C and HIV – however, only 6 percent of patients were tested for hepatitis C and 29 percent for HIV. This is critical, as both Hepatitis C and HIV are treatable.
• Guidelines recommend that all patients initiated on buprenorphine receive liver functioning testing to monitor for liver injury, but only 8 percent of patients were given liver functioning tests.
• Guidelines recommend urine drug testing at initiation of buprenorphine treatment and frequently during treatment. However, only 33 percent of patients received at least one urine drug test over a six-month period after starting medications for OUDs.
• Staying on treatment a long enough time is critical recovery from OUDs. Yet only 47 percent of patients stayed on buprenorphine for at least 6 months.

“The treatment with medications is expanding,” said Dr. Mark. “Between 2014 and 2018, new starts for OUD medications increased by more than 300 percent. Now we need to make sure that those life-saving medications are being used optimally to maximize their benefit.”

“So much of the recent policy focus has been on increasing access to buprenorphine and other OUD medications and we should not lose sight of the need to provide these services in a guideline-consistent way,” said Jesse Hinde, PhD, of RTI. “We may be missing opportunities to better train providers in best practices and to assist providers with quality improvement support.”

Learn more about our work in addiction quality improvement.