Pharmacist-Led Discharge Counseling and Adherence to Postpartum Venous Thromboembolism Prophylaxis: A Pre-Post Observational Study.

Buprenorphine is an effective treatment for opioid use disorder (OUD) that reduces mortality risk but remains underutilized. In 2022, only 1 in 4 US adults who needed medications for OUD (MOUD) received them. Pharmacy- and patient-level barriers can undermine efforts to expand access to buprenorphine through clinician prescribing. Prior research found that 32% of buprenorphine prescriptions written during 2015 to 2019 were not dispensed. We sought to examine characteristics associated with abandonment of newly prescribed buprenorphine—defined as a prescription that was written but not dispensed or filled—and trends in abandonment among adults during 2020 to 2024 to inform efforts to improve buprenorphine access. This retrospective cohort study used deidentified electronic health records (EHR) data linked with administrative claims from the Optum Labs Data Warehouse. The claims data include commercial and Medicare Advantage (MA) enrollees; the EHR data include individuals receiving care from US participating health care groups and organizations. More details on this data including the linkage method are available elsewhere. We followed the reporting guideline. Institutional review board review and informed consent were not applicable because deidentified secondary data were used in accordance with 45 CFR §46. We identified the first prescribed buprenorphine prescription for OUD (prescribing date as index date) of a patient aged 18 years or older between January 1, 2020, and September 25, 2024, in EHR data. With the linked claims data, we included patients who were continuously enrolled with both medical and pharmacy benefits for at least 180 days before the index date and at least 30 days after (with a ≤45-day gap in coverage) (eMethods and eFigures 1-2 in ).