Dose Patterns among patients using low-dose buprenorphine patches

Abstract

Objective: The objective of this study was to investigate the dose pattern of low-dose buprenorphine patches among patients in Swedish clinical practice. The clinical experts among the coauthors interpreted the results in relation to possible indications of development of tolerance and/or dependence/addiction. Design and Setting: This was a nationwide, observational study using data from the Swedish Prescribed Drug Register. Subjects: Individuals who were dispensed the low-dose buprenorphine patches continuously for more than 24 weeks during July 1, 2005 to February 28, 2011 were included. Methods: The dose pattern was analyzed as the change in dose over time for each patient: 1) the dose at baseline compared with each of the following 8-week intervals, and 2) the dose at baseline compared with the dose during the patients' last treatment period. Results: The majority of the patients were female (74%), and most were 75 years and older (69%). The median treatment duration was 260 days, and 4% and 1% of patients remained on continuous treatment for 2 and 3 years, respectively. The mean dose was 11μg/h at baseline, and 15μg/h during the patients' last treatment period. The average dose increased by 4μg/h during the patients' entire treatment course. Conclusions: The average dose increased by 4μg/h during the patients' treatment course, which lasted on an average of 260 days. From a clinical perspective, the dose increase of 4μg/h is low and does not suggest dependence/addiction, as also supported by the low proportion of patients remaining on continuous treatment. © 2013 American Academy of Pain Medicine.