Background: Adolescents and young adults (AYA) face distinct barriers when accessing care for opioid use disorder (OUD). Our objective was to compare characteristics of young adults to older adults seeking buprenorphine via telehealth and examines retention in care.
Methods: This retrospective cohort study compares young adults (ages 18-29) to older callers (age 30 and above) prescribed buprenorphine via a health system-based telehealth bridge clinic, CareConnect, in Philadelphia, Pennsylvania from 2021 to 2023. We compared patient and treatment characteristics using χ2 tests. Interactions between the age groups and independent variables were analyzed. Significant interactions were retained. Multivariable logistic regression evaluated factors associated with buprenorphine retention.
Results: Of the 1023 telehealth callers, 152 (15%) were young adults. The majority identified as male (60%) and were enrolled in Medicaid (74%). Of the sample, 45% identified as White, 36% identified as Black, and 12% identified as Hispanic. Young adult callers were more likely to identify as Hispanic than older callers (19% vs. 11%, P<0.03) and more likely to report incarceration in the last 1 month (17% vs. 9%, P<0.03). There were no significant differences in buprenorphine retention between younger and older adults. Lack of insurance among all adults was associated with lower odds of retention in buprenorphine treatment than insured patients (aOR=0.4, 95% CI=0.2-0.6). Young adults who identified as Black had lower odds of buprenorphine retention(aOR=0.3, 95% CI=0.1-0.8).
Conclusions: Our study highlights the importance of insurance coverage to support continued buprenorphine treatment engagement. This analysis also underscores the need for interventions to mitigate OUD treatment disparities among minoritized young.
Keywords: Retention in care; buprenorphine; buprenorphine initiation; medications for opioid use disorder; opioid use disorder; telehealth; young adults.
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