2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T787,It is unclear how long youth with opioid use disorder (OUD) should continue taking buprenorphine, and what adherence they should achieve. We identified patterns of duration/adherence and assessed associations with subsequent overdose, emergency department (ED) use, and hospitalization. This retrospective cohort analysis used 2014-2022 data from the Massachusetts Public Health Data Warehouse. We identified youth aged 13 to 26 years initiating buprenorphine and used group-based trajectory modeling to categorize youth into duration/adherence trajectories over 12 months. Using multivariable Cox regression, we examined associations between trajectories and time to fatal/nonfatal opioid overdose, all-cause ED use, and all-cause hospitalization during the subsequent 12-month period. Among 11 649 Massachusetts youth initiating buprenorphine, most were aged 21 years or older (89.0%), male (60.3%), white non-Hispanic (85.9%), and enrolled in Medicaid (55.4%). We identified 4 patterns of medication use: (1) high adherence for 12 months (23.7%); (2) low adherence for 12 months (27.5%); (3) discontinuation in 3 to 9 months (16.4%); and (4) discontinuation in less than 3 months (32.5%). Trajectories included 580 (5.0%) and 774 (6.6%) youth switching to methadone and naltrexone, respectively. Compared with high adherence for 12 months, overdose risk was higher with low adherence for 12 months (adjusted hazard ratio [aHR], 1.46; 95% CI, 1.24-1.73), discontinuation in 3 to 9 months (aHR, 1.82; 95% CI, 1.52-2.17), and discontinuation in less than 3 months (aHR, 1.76; 95% CI 1.50-2.06). Compared with high adherence, low adherence and discontinuation in less than 3 months had higher risk of ED use, and all other trajectories had higher risk of hospitalization. Medication adherence may prevent overdose, ED use, and hospitalization. Strategies to increase treatment duration/adherence likely avert harm.31:Ta35, OBJECTIVES It is unclear how long youth with opioid use disorder (OUD) should continue taking buprenorphine, and what adherence they should achieve. We identified patterns of duration/adherence and assessed associations with subsequent overdose, emergency department (ED) use, and hospitalization. METHODS This retrospective cohort analysis used 2014–2022 data from the Massachusetts Public Health Data Warehouse. We identified youth aged 13 to 26 years initiating buprenorphine and used group-based trajectory modeling to categorize youth into duration/adherence trajectories over 12 months. Using multivariable Cox regression, we examined associations between trajectories and time to fatal/nonfatal opioid overdose, all-cause ED use, and all-cause hospitalization during the subsequent 12-month period. RESULTS Among 11 649 Massachusetts youth initiating buprenorphine, most were aged 21 years or older (89.0%), male (60.3%), white non-Hispanic (85.9%), and enrolled in Medicaid (55.4%). We identified 4 patterns of medication use: (1) high adherence for 12 months (23.7%); (2) low adherence for 12 months (27.5%); (3) discontinuation in 3 to 9 months (16.4%); and (4) discontinuation in less than 3 months (32.5%). Trajectories included 580 (5.0%) and 774 (6.6%) youth switching to methadone and naltrexone, respectively. Compared with high adherence for 12 months, overdose risk was higher with low adherence for 12 months (adjusted hazard ratio [aHR], 1.46; 95% CI, 1.24–1.73), discontinuation in 3 to 9 months (aHR, 1.82; 95% CI, 1.52–2.17), and discontinuation in less than 3 months (aHR, 1.76; 95% CI 1.50–2.06). Compared with high adherence, low adherence and discontinuation in less than 3 months had higher risk of ED use, and all other trajectories had higher risk of hospitalization. CONCLUSIONS Medication adherence may prevent overdose, ED use, and hospitalization. Strategies to increase treatment duration/adherence likely avert harm. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Partial Opioid Agonist: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Partial Opioid Agonist (modality). Clinician-written summaries and actionable practice insights. 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Statistical significance, confidence intervals, and detailed demographic breakdowns could not be verified.","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously given the single-site, non-randomized design, but the intervention represents a scalable, EHR-integrated model with clear outcome improvements.","value_numeric":null}],"summaries":{"practice_takeaway":"Embedding chief complaint–triggered electronic alerts with provider education in a PED can meaningfully raise naloxone and buprenorphine provision for at-risk adolescents without driving more return visits. EDs caring for adolescents should consider implementing similar BPA-driven OUD screening pathways.","what_studied":"This quality improvement (QI) initiative evaluated whether electronic Best Practice Alerts (BPAs) triggered by specific chief complaints — combined with provider education, formulary changes, and clinical pathways — could increase naloxone dispensing and buprenorphine prescribing for adolescents with opioid use disorder (OUD) in a pediatric emergency department (PED) over a 45-month period.","key_result":"Among patients with BPA-qualifying chief complaints, naloxone dispensing rose from 3.89% to 11.39% and buprenorphine prescribing rose from 1.04% to 2.46% post-implementation; overall naloxone prescribing across all PED visits increased from 0.40% to 0.79%. In total, 63 adolescents initiated buprenorphine and 246 received naloxone. Black/African American adolescents and those with government insurance received more medications post-implementation. BPA-triggered encounters had longer ED stays but no increase in return visits.","limitations":"Single-site QI study limits generalizability. The full-text was not accessible for review — findings are drawn from the abstract alone, so confounders and statistical significance details are unavailable. Absolute prescribing rates remain low even post-intervention, suggesting substantial room for improvement."}},{"doi":"10.1080/10903127.2026.2668009","pmid":"42114053","title":"The Role of Emergency Medical Services in Addressing Opioid Use Disorder – A Position Statement and Resource Document of NAEMSP","journal_title":"Prehospital Emergency Care","journal_issn":"1090-3127","published_at":"2026-05-11T00:00:00.000Z","url":"https://doi.org/10.1080/10903127.2026.2668009","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-18T13:25:33.074Z","updated_at":"2026-05-18T13:25:33.074Z","tags":[{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"brand","value":"Narcan","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"condition","value":"Opioid Overdose","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"condition","value":"Opioid Use Disorder","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"generic","value":"buprenorphine","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"generic","value":"naloxone","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"modality","value":"Opioid Antagonist","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"modality","value":"Partial Opioid Agonist","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"study_design","value":"Position Statement / Consensus Guideline","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"warning","value":"Brand tag 'Narcan' added as the most recognized naloxone brand, though the paper does not explicitly name it — other naloxone formulations exist.","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"warning","value":"The age group tag defaults to 'adult' as the paper does not specify pediatric populations, though OUD can affect adolescents as well.","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"warning","value":"This is an expert consensus position statement, not an original clinical trial — level of evidence reflects opinion/guideline rather than experimental data.","value_numeric":null}],"summaries":{"what_studied":"This NAEMSP position statement evaluates the role of EMS in addressing opioid use disorder (OUD), covering harm reduction, prehospital medications for OUD (MOUD), alternate dispositions, naloxone distribution, and clinician education.","key_result":"NAEMSP recommends EMS agencies establish low-barrier protocols for prehospital buprenorphine administration, integrate community harm-reduction resources, support alternate patient destinations, expand naloxone distribution, and deliver comprehensive anti-stigma education for EMS clinicians.","limitations":"This is a position statement rather than an original study — recommendations are based on existing evidence synthesis without new primary data or formal meta-analysis. Implementation feasibility may vary widely by local EMS system scope-of-practice laws and resources.","practice_takeaway":"EMS medical directors should work now to authorize buprenorphine in prehospital protocols and connect overdose patients to treatment rather than defaulting to ED transport. Harm-reduction strategies like naloxone distribution and stigma-focused training should be standard across EMS systems."}},{"doi":"10.1542/peds.2025-071147","pmid":"41248890","title":"Buprenorphine Treatment Duration and Adherence Among Youth and Subsequent Health Outcomes","journal_title":"Pediatrics","journal_issn":"0031-4005","published_at":"2025-11-18T00:00:00.000Z","url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12662019","source_score":179,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-11-22","doi":"10.1542/peds.2025-071147","days":"14","issn":"0031-4005","rank":"5","field":"Clinical Medicine","score":"179","category":"Pediatrics","categories":["Pediatrics"],"_categories":["Pediatrics"]},"pubmed":{"doi":"10.1542/peds.2025-071147","title":"Buprenorphine Treatment Duration and Adherence Among Youth and Subsequent Health Outcomes.","journal":"Pediatrics","methods":"","results":"Among 11 649 Massachusetts youth initiating buprenorphine, most were aged 21 years or older (89.0%), male (60.3%), white non-Hispanic (85.9%), and enrolled in Medicaid (55.4%). We identified 4 patterns of medication use: (1) high adherence for 12 months (23.7%); (2) low adherence for 12 months (27.5%); (3) discontinuation in 3 to 9 months (16.4%); and (4) discontinuation in less than 3 months (32.5%). Trajectories included 580 (5.0%) and 774 (6.6%) youth switching to methadone and naltrexone, respectively. Compared with high adherence for 12 months, overdose risk was higher with low adherence for 12 months (adjusted hazard ratio [aHR], 1.46; 95% CI, 1.24-1.73), discontinuation in 3 to 9 months (aHR, 1.82; 95% CI, 1.52-2.17), and discontinuation in less than 3 months (aHR, 1.76; 95% CI 1.50-2.06). Compared with high adherence, low adherence and discontinuation in less than 3 months had higher risk of ED use, and all other trajectories had higher risk of hospitalization.","abstract":"$30","keywords":[],"pubmed_id":"41248890","conclusions":"","publication_date":"2025-11-18T00:00:00"},"crossref":{"DOI":"10.1542/peds.2025-071147","URL":"https://doi.org/10.1542/peds.2025-071147","ISSN":["0031-4005","1098-4275"],"link":[{"URL":"https://publications.aap.org/pediatrics/article-pdf/doi/10.1542/peds.2025-071147/1889916/pediatrics.2025071147.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https://publications.aap.org/pediatrics/article-pdf/doi/10.1542/peds.2025-071147/1889916/pediatrics.2025071147.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"6","score":1,"title":["Buprenorphine Treatment Duration and Adherence Among Youth and 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Massachusetts"}]},{"given":"Wei-Hsuan","family":"Lo-Ciganic","sequence":"additional","affiliation":[{"name":"6Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania"},{"name":"7Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh, Pittsburgh, Pennsylvania"},{"name":"8Center for Clinical Artificial Intelligence, University of Pittsburgh, Pittsburgh, Pennsylvania"},{"name":"9North Florida/South Georgia Veterans Health System Geriatric Research Education and Clinical Center, Gainesville, Florida"}]},{"given":"Sarah M.","family":"Bagley","sequence":"additional","affiliation":[{"name":"3Boston Medical Center, Boston, Massachusetts"},{"name":"4Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"}]},{"given":"Jessica B.","family":"Calihan","sequence":"additional","affiliation":[{"name":"3Boston Medical Center, Boston, Massachusetts"},{"name":"4Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"}]},{"given":"Heather E.","family":"Hsu","sequence":"additional","affiliation":[{"name":"3Boston Medical Center, Boston, Massachusetts"},{"name":"4Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"}]},{"given":"Marc R.","family":"Larochelle","sequence":"additional","affiliation":[{"name":"3Boston Medical Center, Boston, Massachusetts"},{"name":"4Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"}]}],"issued":{"date-parts":[[2025,11,18]]},"member":"417","prefix":"10.1542","source":"Crossref","volume":"156","created":{"date-time":"2025-11-18T00:02:42Z","timestamp":1763424162000,"date-parts":[[2025,11,18]]},"indexed":{"date-time":"2025-12-01T00:02:23Z","timestamp":1764547343900,"date-parts":[[2025,12,1]]},"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://publications.aap.org/pediatrics/article/156/6/e2025071147/205461/Buprenorphine-Treatment-Duration-and-Adherence"}},"subtitle":[],"deposited":{"date-time":"2025-11-30T23:57:30Z","timestamp":1764547050000,"date-parts":[[2025,11,30]]},"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"published":{"date-parts":[[2025,11,18]]},"publisher":"American Academy of Pediatrics (AAP)","reference":[{"DOI":null,"key":"2025113018572172900_r1","year":"2024","issue":null,"author":"Substance Abuse and Mental Health Services 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Disorder","value_numeric":null},{"paper_doi":"10.1542/peds.2025-071147","tag_type":"generic","value":"buprenorphine","value_numeric":null},{"paper_doi":"10.1542/peds.2025-071147","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1542/peds.2025-071147","tag_type":"modality","value":"Partial Opioid Agonist","value_numeric":null},{"paper_doi":"10.1542/peds.2025-071147","tag_type":"sample_size","value":"n=11649","value_numeric":11649},{"paper_doi":"10.1542/peds.2025-071147","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1542/peds.2025-071147","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1542/peds.2025-071147","tag_type":"warning","value":"Adherence/duration groups were defined by trajectory modeling; operational details are not provided here.","value_numeric":null},{"paper_doi":"10.1542/peds.2025-071147","tag_type":"warning","value":"Effect sizes for ED use and hospitalization were not reported in the excerpt beyond directional statements.","value_numeric":null},{"paper_doi":"10.1542/peds.2025-071147","tag_type":"warning","value":"Study design classification is based on the provided abstract and methods summary.","value_numeric":null}],"summaries":{"what_studied":"A retrospective cohort of Massachusetts youth aged 13–26 initiating buprenorphine (2014–2022) grouped 12‑month duration/adherence trajectories and examined associations with overdose, emergency department (ED) use, and hospitalization in the following 12 months.","key_result":"Among 11,649 youth, four patterns emerged: high adherence 12 months (23.7%), low adherence 12 months (27.5%), discontinuation 3–9 months (16.4%), and discontinuation <3 months (32.5%); versus high adherence, overdose risk was higher with low adherence (aHR 1.46; 95% CI 1.24–1.73), discontinuation 3–9 months (1.82; 1.52–2.17), and <3 months (1.76; 1.50–2.06). Low adherence and <3‑month discontinuation had higher ED use, and all other trajectories had higher hospitalization.","practice_takeaway":"For youth with OUD on buprenorphine, maintaining high adherence for 12 months was associated with lower overdose, ED use, and hospitalization than lower adherence or early discontinuation; support 12‑month adherence to reduce harm."}}],"initialOffset":3,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Partial Opioid Agonist"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Partial Opioid Agonist"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Partial Opioid Agonist"}}}]]

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