Dramatic Improvement in Outpatient Opiate-free Exits Using a Novel Resource-efficient Lofexidine-based Protocol (bristol-regime) – a Service Evaluation Study - 09/06/15
Résumé |
Introduction |
Lofexidine is an alpha-2-A noradrenergic receptor agonist approved in the United Kingdom for treating opioid withdrawal symptoms. Due to relatively poor detox success rates locally, we introduced a novel regime – the BristoL (Buprenorphine-Lofexidine) protocol (table 1):
• | Only four outpatient appointments over 14 days. |
• | Buprenorphine front-loading (days 1-3) |
• | Lofexidine (days 5-14) |
• | Naltrexone offered on day 12 |
Objectives |
We assessed the efficacy of this regime in our outpatients (annual numbers coming into treatment 120-150/year) compared to previous client-led regimes.
Methods |
Retrospective case notes review and electronic patient management software were used to calculate changes in opiate-free exits.
Results |
Drug free exits in the first year after introducing the BristoL protocol dramatically increased by 140% (from 5 to 12) and doubled again the following year (29) with comparable figures the year after (26) demonstrating a sustained effect (figure 1).
Conclusions |
Introducing the BristoL protocol led to a dramatic improvement in opiate-free exits over three years with good tolerability and no significant side effects. Its advantages – simplified prescribing, reduced monitoring and a dramatically improved reported patient experience – have meant we are now also using it in the primary care setting.
Vol 30 - N° S1
P. 475a - mars 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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