Exploring patient experience and satisfaction with depot buprenorphine formulations: A mixed-methods study

Drug Alcohol Rev. 2023 May;42(4):791-802. doi: 10.1111/dar.13616. Epub 2023 Feb 14.

Abstract

Introduction: The introduction of depot buprenorphine for the treatment of opioid dependence allows for reduced dosing frequency compared with conventional treatments, such as oral methadone and sublingual buprenorphine-naloxone. Reduced dosing frequency is perceived to reduce issues such as high out-of-pocket costs, frequent attendance to pharmacies, stigmatisation and the risk of diversion for unsanctioned opioid use. This study aims to explore the experiences of patients receiving depot buprenorphine from an Australian publicly operated drug and alcohol service.

Methods: Participants were recruited from the service over a 5-week period in 2021. Twenty-eight participants consented to be involved in a mixed methods quantitative verbal survey and qualitative interview process.

Results: The majority of participants reported satisfaction with depot buprenorphine across the domains of efficacy, convenience and global satisfaction. Participants perceived benefits as increased convenience, reduced stigmatisation and the inability to 'skip' daily Medication Assisted Treatment for Opioid Dependence (MATOD) doses. There were mixed experiences with the ability for depot buprenorphine to 'hold' participants throughout the dosing interval. Reduced contact and disconnection from healthcare services were reported as an issue for some participants when initiating depot buprenorphine.

Discussion and conclusions: Patient perceptions of depot buprenorphine appear to be deeply rooted in prior experience with 'conventional' MATOD treatments. Depot buprenorphine is seen to be beneficial socially, personally, and financially by the majority of patients interviewed. The potential for disconnection from services and mixed experiences of efficacy throughout the dosing period may negatively influence patient experience.

Keywords: buprenorphine; opiate substitution treatment; opioid-related disorders; qualitative research; social stigma.

MeSH terms

  • Analgesics, Opioid
  • Australia
  • Buprenorphine* / therapeutic use
  • Buprenorphine, Naloxone Drug Combination / therapeutic use
  • Humans
  • Methadone
  • Narcotic Antagonists / therapeutic use
  • Opiate Substitution Treatment / methods
  • Opioid-Related Disorders* / drug therapy
  • Patient Outcome Assessment
  • Patient Satisfaction

Substances

  • Buprenorphine
  • Methadone
  • Buprenorphine, Naloxone Drug Combination
  • Analgesics, Opioid
  • Narcotic Antagonists