A medication assisted tier-based approach to treating opioid use disorder: a retrospective chart review Public Deposited

Background: Opioid use disorder has reached epidemic proportions in the United States. Medical treatment options available include buprenorphine (BUP) and buprenorphine/naloxone (Suboxone). Research that identifies what factors increase patient success and their movement through a tier-based MAT program is limited. Methods: This was a retrospective chart review of 18 patients enrolled in the MAT program at OHSU Family Medicine in Scappoose between September 1, 2016 and December 31, 2018. Electronic medical records were reviewed to abstract data on basic demographics, engagement, and tier status throughout the program. Participants: Any patient greater than 18 years of age who holds a current diagnosis of OUD with at least 10 related clinic visits. Results: Seven patients met or maintained Tier 4 or Tier Y. Nine patients were maintained at or above 16mg of buprenorphine. 55.6% had a positive UDS during the time period. Average number of days in the program was 389.72 (range 93-772), with 32 visits, 42.8% of which were with a medical provider. Average number of days in a particular tier was 65 days in tier 1, 76 days in tier 2, 115 days in tier 3, and 91 days in tier 4. Conclusions: There are distinctive demographics and factors that influence patient success in a MAT program. Based on this sample, there are distinct patterns of stability through tiers, which suggest OUD is a chronic disease often accompanied by cycles of relapse and remission that require continued treatment in order to be successful.

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