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Article
Title A pilot study about the feasibility and cost-effectiveness of electronic compliance monitoring in substitution treatment with buprenorphine-naloxone combination 
Author Tacke Ulrich, Uosukainen Hanna, Kananen Marjo, Kontra Kirsi, Pentikaenen Hannu  
Article Information Abstract
Publication Journal of opioid management  OBJECTIVES: The purpose of the study was to investigate whether or not
compliance monitoring by microchip could offer a feasible method for
reducing abuse and/or diversion of medication from unsupervised
substitution treatment for opioid addiction. DESIGN: Naturalistic, 4-week
pilot study in out patients. PATIENTS AND INTERVENTIONS: All our
patients (N = 12) on buprenorphine-naloxone combination (Suboxone)
received their medication for 6 days in a compliance-monitoring
device (PharmaDDSi, StoraEnso), which registers date and time of
tablet removal. Patients were instructed to take all tablets as one
dose. Time cues were displayed and discussed with the patients during
their weekly visits for supervised drug administration and
counseling. MAIN OUTCOME MEASURES: Regularity of registered time
cues, treatment costs in comparison with routine treatment, patients'
answers from a questionnaire on acceptability, and effect on drug
diversion. RESULTS: Six patients showed good compliance, in two
patients irregularities were minor, but in two others lack of
adherence to treatment instructions was detected. Patients with
several comorbid psychiatric diagnoses showed on an average the
longest intervals between removal of first and last tablet of the
daily dose. One-fourth of the patients reported that compliance
monitoring had helped to avoid diversion. Total cost savings during the
4-week period was a reduction of 39 percent, which was mainly due to
fewer visits to the clinic. CONCLUSIONS: Compliance monitoring by
PharmaDDSI with weekly feedback was well accepted and subjectively
increased compliance with substitution treatment. Future studies will
show whether a technical solution for compliance monitoring in real
time can help to reduce drug abuse and noncompliance in substitution
treatment and other opioid treatments.


Reference BUPP10048 
Year 2009 
Logged 02/02/2010 
Volume
Part
Pages 321-9 
ISSN 1551-7489 
Keywords  
Comparison Drug  
Language English 

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