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 11 mu g/h at baseline, and 15 mu g/h during the patients' last treatment period. The average dose increased by 4 mu g/h during the patients' entire treatment course. Conclusions The average dose increased by 4 mu g/h during the patients' treatment course, which lasted on an average of 260 days. From a clinical perspective, the dose increase of 4 mu g/h is low and does not suggest dependence/addiction, as also supported by the low proportion of patients remaining on continuous treatment.