{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:11:50Z","timestamp":1783656710511,"version":"3.55.0"},"reference-count":50,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Buprenorphine is effective for opioid use disorder (OUD), yet adherence remains suboptimal. This study aimed to identify adherence trajectories, explore their predictors, and assess their association with opioid overdose risk and healthcare costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using the Merative MarketScan Commercial Database, which includes a nationally representative sample of individuals with private, employer\u2010sponsored health insurance in the United States. We included adults (\u2265\u200916\u2009years) with OUD who initiated and completed at least 30 consecutive days of buprenorphine treatment between July 2017 and June 2019, with a 180\u2010day follow\u2010up. Group\u2010based trajectory modelling identified distinct adherence patterns. Multinomial logistic regression examined predictors of adherence trajectories. A discrete\u2010time survival model estimated the association between adherence and opioid overdose risk, while generalised linear models assessed healthcare costs. Sensitivity analyses, including E\u2010value calculations, evaluated residual confounding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 5107 individuals (median [Q1\u2010Q3] age in years: 37 [26\u201347]; 3185 [62.4%] male), three distinct buprenorphine adherence trajectories were identified in the follow\u2010up period: consistent adherence (CA, 49.5%), slow\u2010declining adherence (SDA, 28.0%) and rapidly\u2010declining adherence (RDA, 22.5%) trajectory groups. The mean (95% CI) time to buprenorphine discontinuation among all beneficiaries was 153 (151\u2013155) days. Compared to the CA group, SDA and RDA groups had 2.74 (95% CI 2.71\u20132.77) and 3.81 (95% CI: 3.76\u20133.86) times higher opioid overdose risk and $13,670 (95% CI $7644\u2013$19,695) and $19,431 (95% CI $13,632\u2013$25,229) higher healthcare spending, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>Consistent adherence to buprenorphine was associated with a lower risk of opioid overdose and reduced healthcare expenditures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70035","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T09:10:40Z","timestamp":1757581840000},"page":"1907-1919","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Buprenorphine Adherence Trajectories and Their Impact on Opioid Overdose and Healthcare Costs"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5775-5637","authenticated-orcid":false,"given":"Olajumoke A.","family":"Olateju","sequence":"first","affiliation":[{"name":"The Prescription Drug Misuse Education and Research (PREMIER) Center, University of Houston  Houston Texas USA"},{"name":"Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9795-8837","authenticated-orcid":false,"given":"Tyler","family":"Varisco","sequence":"additional","affiliation":[{"name":"The Prescription Drug Misuse Education and Research (PREMIER) Center, University of Houston  Houston Texas USA"},{"name":"Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Weiner","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Department of Emergency Medicine Havard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6017-7500","authenticated-orcid":false,"given":"Douglas","family":"Thornton","sequence":"additional","affiliation":[{"name":"The Prescription Drug Misuse Education and Research (PREMIER) Center, University of Houston  Houston Texas USA"},{"name":"Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000075"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-018-0094-5"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2017.1404106"},{"key":"e_1_2_11_5_1","unstructured":"US Centers for Medicare & Medicaid Services \u201cQuality ID #468: Continuity of Pharmacotherapy for Opioid Use Disorder (OUD) \u201d2024."},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/SAR.S150253"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.108062"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2022.3118"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108317"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2013.02.008"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.0228.x"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2016.03.1371"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2019.05.015"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4647"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001458"},{"key":"e_1_2_11_16_1","unstructured":"United States Census Bureau \u201cHealth Insurance Coverage in the United States: 2023 \u201dn.d. accessed December 4 2024 https:\/\/www.census.gov\/library\/publications\/2024\/demo\/p60\u2010284.html."},{"key":"e_1_2_11_17_1","unstructured":"Kaiser Family Foundation \u201cEmployer Health Benefits Survey \u201d2024."},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","unstructured":"J. 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