{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T17:18:42Z","timestamp":1779297522803,"version":"3.51.4"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003945","name":"Link\u00f6ping University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003945","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Growing evidence supports long-acting injectable (LAI) buprenorphine in opioid use disorder treatment. Implementation is limited due to concerns about costs as well as potential reduction of support, which could increase strain on health care services. This real-life study follows clinical patients one year prospectively and one year retrospectively from switching from daily sublingual or peroral opioid agonist treatment (OAT) to LAI buprenorphine exploring how this impacts days of inpatient care and emergency room (ER) visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From electronic medical records, from four Swedish OAT clinics, we identified all patients (n=128) who had switched from sublingual or peroral OAT, to LAI buprenorphine during the first two years of implementation (2019-2021 in three clinics, 2021\u20132023 in the fourth). In this within-subject mirror study, patients served as their own controls. The number of days of inpatient care and ER visits were extracted from the electronic medical records using a standard operating procedure. Quasi-Poisson models were used to compare health care utilization before and after starting LAI buprenorphine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 128 patients, 28 (22%) were female and mean age was 37.8 (SD 9.0) years. Days of inpatient care were reduced by half, dropping from an average of 9.0 to 4.5 days (incidence rate ratio [IRR]: 0.5, 95% CI 0.41\u20130.61, p&lt;.001), with a health care cost reduction of SEK 45,081 (~USD 4,090) per patient. The decline in days of inpatient care was even steeper among the 85 patients who remained on LAI buprenorphine treatment at 12 months (IRR 0.26, 95% CI 0.20\u20130.34, p&lt;.001), with a decrease in health care costs of SEK 73,210 (~USD 6,642) per patient. ER visits showed no significant change (IRR: 0.93, 95%CI 0.79 - 1.09). One-year treatment retention to LAI buprenorphine was high (67%). Most patients who discontinued LAI buprenorphine transitioned to other sublingual\/peroral forms of OAT, resulting in an overall OAT continuation rate of 89%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementation of LAI buprenorphine in OAT clinical settings was associated with a significant reduction in inpatient care and substantially reduced health care costs. These results challenge common economic hesitations and support wider integration of LAI options in opioid use disorder treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-025-13607-7","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T08:49:30Z","timestamp":1761122970000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Reduced need for inpatient care following introduction of long-acting injectable buprenorphine"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3551-7232","authenticated-orcid":false,"given":"Emelie","family":"Gauffin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Marques Franca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Pizzaro Ferrero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeb","family":"Freij","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isa","family":"Pihlflyckt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikael","family":"Sandell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Gedeon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"He","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Andersson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8159-1249","authenticated-orcid":false,"given":"Gustav","family":"Tingh\u00f6g","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1758-2206","authenticated-orcid":false,"given":"Andrea","family":"Johansson Capusan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"issue":"5","key":"13607_CR1","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1001\/jamapsychiatry.2019.4170","volume":"77","author":"S Larney","year":"2020","unstructured":"Larney S, Tran LT, Leung J, Santo T Jr, Santomauro D, Hickman M, et al. 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The study adhered to the Helsinki Declaration. The study was submitted for consideration, comment, guidance, and approval by the national Swedish Ethics Review Authority, before start. Obtaining individual consent to participate and for publication is not necessary or applicable in this case. The study is based on electronic medical records data, which is similar to register-based research and to quality data within the health care system. Research data are exclusively based on already given treatment according to clinical routines, registered in electronic medical records. The study does not in any way affect the treatment or treatment access of any individual or expose participants to any risks. Conversely, the risk of only collecting data from patients where consent can be obtained, is that the most unstable patients, who may not be possible to contact for different reasons (no longer are at the clinic, in inpatient or treatment facilities elsewhere, incarcerated or deceased) would not to be included in the follow-up. This would risk biasing results towards more positive outcomes and spuriously increase the positive effects of the treatment. Individual consent was waived by the Ethics Review Authority. Similar approaches are used in the clinical follow up of other severe conditions such as cancer treatment. Data is coded and analyzed and presented at a group level, where no individual participants are possible to identify, to ensure integrity of the participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable. No individual level data are presented in this manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"AJC has received speaker\u2019s fees and participated in advisory board meetings for Indivior, Dne pharma, Camurus, Nordic Drugs, Lundbeck, all outside the scope of this study. MS has served as consultant and received speaker\u2019s fees from Indivior, Camurus, Dne pharma and Nordic Drugs all outside the scope of this work. For the remaining co-authors none were declared.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1397"}}