Lee Middleton
Glasgow Alc0hol & Drug Recovery Service.
Improved recovery outcomes with injectable prolonged-release buprenorphine in an opioid agonist therapy clinic in Glasgow
Aims: Prior to Scottish Medicines Committee approval and wider use of the newly licenced injectable prolonged release buprenorphine (IPRB) product, community services in Glasgow were keen to gain experience via a pilot project.
Design: Patients established on supervised sublingual buprenorphine (SLBUP), regular attenders with no recent problematic alcohol/drug use, non-fatal OD, outstanding physical health issues or other instalment dispensed medication, were offered transfer to IPRB via pilot protocol and monitored for 12 weeks.
Setting: Two Glasgow Alcohol and Drug Recovery Service community care and treatment teams.
Participants: 20 patients identified via multidisciplinary discussion – 18 male (90%), mean age 43.5(±7.0), average SLBUP dose 16.9mg (range 4mg-24mg).
Intervention: Patients were initially transferred to equivalent weekly IPRB injections, before monthly IPRB injections for maintenance.
Measurements: Acceptability of transfer, patient and practitioner experience, medication dose, reported drug use/urine drug screens, engagement with structured recovery activity/employment.
Findings and conclusions: 20 patients offered transfer to IPRB. 6 declined (majority due to injection/needle issues). No significant differences between those who accepted or declined. 14 completed transfer to IPRB with very positive feedback. Injection described as painful but not to extent to stop treatment. One patient requested return to SLBUP as preferred to take daily medication. No difference in drug use (pre-IPRB 9/13(69%), on-IPRB 6/13(46%), p=0.23). Statistically significant increase in number engaged in employment/structured activities following transfer (pre-IPRB 4/13(31%), on-IPRB 12/13(92%), p=0.0016). Staff experience: needle bore wider than anticipated; injection technique improved by holding in place for 10 seconds after injection. Analysis is on-going and updated results will be presented.