Dr Bernadette Hard

Kaleidoscope Project

A local service evaluation to describe the use of Espranor® on treatment adherence and on-top opioid usage of patients receiving opioid substitution therapy

Dr Bernadette Hard

Kaleidoscope Project


Espranor® is a novel, rapidly-dissolving oral formulation of buprenorphine used for opioid substitution therapy (OST). Kaleidoscope is a charity supporting vulnerable patients with current or recent Criminal Justice involvement and active substance abuse, a recognised hard-to-reach group. The aim of this service evaluation was to evaluate OST adherence and on-top opioid usage in patients initiated on Espranor®.


A service evaluation (SE) involving a retrospective chart review including all patients aged >=18 years receiving Espranor® in the 6 months post-introduction (January – June 2017) was carried out at 4 Kaleidoscope sites. The observation period for each patient was from Espranor® treatment initiation until discontinuation.


Data from 97 patients were analysed. The mean age at Espranor® initiation was 37.1 (standard deviation [SD]=8.1) years. The mean last dispensed dose of Espranor® was 12.1 mg (SD=4.3). At 6 weeks post-initiation, 55% (53/97) of patients continued Espranor® treatment and 45% (44/97) discontinued treatment. Of the 67 patients tested for opiates at any point during treatment, the number of positive opiate tests was 40% (20/50) in patients continuing treatment for >=6 weeks, and 65% (11/17) in patients who stopped treatment by 6 weeks. Of the 53 patients continuing treatment at >=6 weeks, 17 had a test for opiates during the 6th week, and 88% (15/17) were opiate-free.


The SE results suggest that continuing Espranor® treatment for >=6 weeks may be associated with lower on-top opioid usage in this highly vulnerable patient group.


Mrs Su Mclain-Smith, pH Associates, Marlow; Email: SusanMclain-Smith@phassociates.com

Conflicts of interest:

B. Hard has received honorrarium from Martindale to present at a meeting and also to attend/ present at the Secure Environment Conference in November 2018. S. Mclain-Smith declares no conflicts of interest.