Buprenorphine Episodes of Care
Nicotine replacement therapy receipt among Veterans with tobacco use disorder and OUD
This focus is on examining nicotine replacement therapy (NRT) in individuals diagnosed with opioid use disorder (OUD). This is including patient demographics, type of clinical setting they receive NRT, medication(s), dosing, longevity, comorbidities, and other substance use disorder diagnoses. Comparisons will also be made between Veterans actively receiving buprenorphine for medication-assisted treatment of opioid use disorder (B-MOUD) and those not receiving B-MOUD.
Impact of stimulant use disorder, alcohol use disorder, and heart failure on MOUD initiation and retention
This project is looking at heart failure among patients with an OUD diagnosis. The evaluation will focus on patients with both opioid use disorder (OUD) and heart failure, assessing whether they are receiving B-MOUD, chronic heart failure treatment, and their mortality rates following hospital discharge.
Post-hospitalization mortality of Veterans with OUD
This project is examining the mortality of Veterans with an OUD diagnosis post-hospital discharge. Specifically, this will assess whether these Veterans experience higher mortality rates within the first 90 days post-discharge compared to the period between 91 and 365 days after discharge. Comparisons will also be made between Veterans actively receiving buprenorphine for medication-assisted treatment of opioid use disorder (B-MOUD) and those not receiving B-MOUD.
High Dose Buprenorphine in the Context of Opioid Use Disorder Episodes of Care within the Veterans Health Administration: Characterization and Outcomes
PHASE 1
Characterize VA policy, regulatory environment, restrictions and enablers of prescribing buprenorphine for the treatment of OUD in the VA
Lead: Salt Lake City
Characterize dose patterns of buprenorphine for veterans with OUD (2006-2023)
Lead: Salt Lake City
Evaluate average buprenorphine daily dose and trajectories within Episodes of Care (2006-2020)
Lead: Little Rock
Examination of fatal- and non-fatal overdoses and mortality
Lead: Little Rock
PHASE 2
Examining the Prescriber Perceptions of High Dose Buprenorphine Prescribing
Lead: Salt Lake City
The use of Natural Language Processing to Explore Reasons and Outcomes of High dose Buprenorphine Prescribing
Lead: Salt Lake City
Patient-Level Covariates of High-Dose Buprenorphine Prescribing
Lead: West Haven
Time to B-MOUD discontinuation following initiation
Lead: West Haven
Time to high-dose B-MOUD following initiation
Lead: West Haven
Propensity score-weighted comparison of high- vs. lower-dose B-MOUD exposure on patient outcomes
Lead: West Haven
Profiles of OUD Episodes of Care
Lead: West Haven
Gender and Buprenorphine as medication for OUD
Disparities in access to efficacious medication for opioid use disorder exist for racial and ethnic minority veterans within the VHA. Female veterans are an identified vulnerable group, and proportionally more female veterans belong to racial and ethnic minority groups than their male counterparts. We sought to characterize changing trends in the receipt of buprenorphine care by racial and ethnic groups within the female only cohort of veterans with opioid use disorder to identify intersectional disparities.