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Fig. 2 | Addiction Science & Clinical Practice

Fig. 2

From: Creation of an algorithm for clinical decision support for treatment of opioid use disorder with buprenorphine in primary care

Fig. 2

MBC4OUD Clinical Decision Support Schematic. This figure presents the treatment guidance for three hypothetical patients. Each box contains the time point of evaluation, treatment response shown by the patient at that time point, and the treatment guidance provided by the algorithm for the first 10 weeks of treatment for each patient. The typical situation in which the dose of buprenorphine would be continued unchanged in a patient with a partial response are those in which the patient is continuing to make improvements. A scenario that would follow the example of Patient 2 below is as follows: at Week 0, the patient is using 1 g of heroin daily and is initially stabilized on 8 mg buprenorphine daily. At the week 2 assessment, the patient report that heroin use has decreased in amount but is still occurring daily. In response, the buprenorphine dose is increased to 12 mg daily. At the next visit at week 4, the patient reports 2 days of a small amount of heroin use since last visit. The patient describes this use as “a waste of money” because he did not experience any of the desirable effects of heroin. The patient improvements related to DSM criteria (attending a family gathering, improved relationship with significant other, improvements in work attendance, etc.). The clinician chooses to maintain the current dose of buprenorphine at Week 4. At Week 6, the patient reports no use of heroin since the last visit and achieves full response

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