"Now It's Up to Me to Take Advantage of the Shot": Patient Perspectives on Hospital Initiation of Long-acting Injectable Buprenorphine.

Abstract

The inpatient addiction medicine consult team at West Suburban Medical Center started administering long-acting injectable buprenorphine (LAIB) to hospitalized patients in response to low rates of patients continuing treatment with sublingual buprenorphine after discharge. The aims of this study are to understand patients' motivations to receive LAIB during hospitalization and their experiences with the medication after discharge. We conducted semi-structured interviews with patients who received LAIB while hospitalized between August 2022 and April 2023. Inductive analysis was used to identify themes and develop the codebook. Two researchers independently coded each interview and refined the codebook with oversight from 2 senior members of the research team. After the coding team reviewed each interview together to arrive at a joint consensus, a third coder found concordance in a random sample of interviews. Finally, the entire research team met to discuss key themes. Eighteen participants were interviewed between March and May 2023. The following key themes emerged: (1) limited knowledge and access to LAIB before hospitalization, (2) the role of peer support specialists in deciding to start LAIB while hospitalized, (3) fears around an increasingly unpredictable drug supply and personal experience with overdose as motivations to receive LAIB, (4) benefits of LAIB in multiple areas of participants' lives, and (5) negative aspects of LAIB. Our participants' overall positive experiences with hospital-administered LAIB should inform policymakers and payors to support the expansion of this model and the exploration of additional strategies to lower barriers to LAIB access.