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HIVPhase 4BHIVES-SFNCT00263458

Integrating Buprenorphine Into the SFGH AIDS Program

A Phase 4 study testing Integrated office-based buprenorphine treatment for opioid dependence in an HIV primary care setting in people with HIV and Buprenorphine, run by University of California, San Francisco at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to assess the feasibility, cost, and effectiveness of a model of care designed to integrate buprenorphine treatment for opioid dependence into the HIV primary care clinics at the UCSF Positive Health Program. Read more about this study

Who is it for?
Ages 19 years and older
Conditions the study is for
HIV, Buprenorphine, Opioid Dependence
What is being tested?
Integrated office-based buprenorphine treatment for opioid dependence in an HIV primary care setting
Could I receive a placebo?
No, everyone receives an active treatment
How many people
37 participants
Where
1 siteUnited States
Study dates
Dec 2005to Jun 2009
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 19 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age > 18 years
  • Fluent in English
  • Receive HIV primary care at the UCSF Positive Health Program
  • Meet DSM-IVR criteria for opioid dependence
  • Meet clinical criteria for buprenorphine treatment (see Exclusion Criteria)
  • Plan to stay in the San Francisco Bay Area for the next 12 months

Who cannot join

  • Severe hepatic dysfunction, i.e., AST and/or ALT > 5X upper limit of normal
  • DSM-IV criteria for benzodiazepine abuse or dependence within the past 6 months
  • DSM-IV criteria for alcohol dependence within the past 6 months
  • Actively suicidal
  • Psychiatric impairment that impedes ability to consent (dementia, delusional, actively psychotic)
  • Methadone or opiate analgesic doses exceed level allowing for safe transition to buprenorphine
Show all 10Show fewer
  • Pregnant women and women actively trying to become pregnant
  • Potential subjects also will be excluded for:
  • Any medical condition(s), which, in the opinion of the investigator, would interfere with the patient's ability to participate in or adhere to the requirements of this study
  • Unable or who decline to provide informed consent for the evaluation

Trial locations and contacts

1 site in 1 country.

United States1 site
  • UCSF Positive Health Program

    San Francisco, California, 94110

Other trials in United States

About this study

Official title: Integrating Buprenorphine Into the SFGH AIDS Program (Patient Evaluation Study)

The purpose of this study is to assess the feasibility, cost, and effectiveness of a model of care designed to integrate buprenorphine treatment for opioid dependence into the HIV primary care clinics at the UCSF Positive Health Program.

Read the detailed description

The UCSF Positive Health Program (formerly called the AIDS Program) at San Francisco General Hospital (SFGH) is one of the oldest and largest HIV/AIDS clinics in the United States. Located at the public hospital serving medically indigent residents of San Francisco, the Positive Health Program (PHP) provides over 2,000 patient visits per month to 2,300 patients in a comprehensive HIV primary care setting. The clinic population is disproportionately affected by heroin and other opiate abuse problems. Opiate replacement therapy (ORT) has a stabilizing effect in HIV-infected injecting drug users (IDU) and is associated with greater acceptance of antiretroviral (ARV) therapy, higher ARV adherence, and greater engagement in appropriate HIV-related health care. However, there are insufficient resources to meet the critical substance abuse treatment needs among our opioid-dependent patients.

In partnership with the Community Behavioral Health Services (CBHS) section of the San Francisco Department of Public Health (SFDPH), the UCSF Positive Health Program (PHP) at San Francisco General Hospital (SFGH) has developed a model of care, which provides opioid-dependent patients with integrated, office-based buprenorphine ORT in the HIV primary care setting. The program also offers primary care providers with education and training on addiction, opiate addiction treatment, and the appropriate use of buprenorphine. An evaluation of the program is planned to examine: (1) its effects on the health and substance use of patients; (2) program costs; and (3) what broader impact the program has on providers, institutions, and local systems. In the patient evaluation study, eligible, opioid-dependent patients that receive primary HIV care at the PHP will be randomly assigned to receive buprenorphine ORT for twelve months either in the integrated HIV primary care setting (intervention group) versus a non-integrated substance abuse treatment clinic setting (comparison group). Data will be abstracted from medical chart reviews and will be collected from patients using standardized instruments and satisfaction surveys.

Being tested
Integrated office-based buprenorphine treatment for opioid dependence in an HIV primary care setting
Keywords
HIV, acquired immunodeficiency syndrome, buprenorphine, opioid dependence, opioid-related disorders, integrated care, primary care
Medical subject headings
Opioid-Related Disorders, Acquired Immunodeficiency Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Integrated office-based buprenorphine treatment for opioid dependence in an HIV primary care settingOther

    Also called Suboxone, Subutex

    Eligible opioid-dependent HIV-infected patients are randomly assigned to receive buprenorphine opioid agonist treatment for 12 months either in an integrated HIV primary care setting (intervention group) versus a non-integrated substance use treatment clinic setting (comparison group).

Study groups in NCT00263458
Study groupRoleWhat they receive
IntegratedExperimentalBuprenorphine maintenance treatment delivered at an HIV primary care clinic
Receives: Other: Integrated office-based buprenorphine treatment for opioid dependence in an HIV primary care setting
Non-integratedActive comparatorBuprenorphine maintenance treatment delivered at a public health substance use disorder clinic
Receives: Other: Integrated office-based buprenorphine treatment for opioid dependence in an HIV primary care setting

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Substance use outcomes at 0, 1, 3, 6, 9 and 12 months.

    Measured: 0, 1, 3, 6, 9 and 12 months.

  2. HIV care outcomes at 0, 1, 3, 6, 9 and 12 months.

    Measured: 0, 1, 3, 6, 9 and 12 months

Secondary outcomes (5)
  1. HIV-related health

    Measured: baseline, 1, 3, 6, 9 and 12 months

  2. Quality of life

    Measured: 0, 1, 3, 6, 9 and 12 months

  3. Social functioning

    Measured: 0, 1, 3, 6, 9 and 12 months

  4. Quality of HIV care.

    Measured: 0, 3, 6, 9 and 12 months

  5. Patient satisfaction at 3 months.

    Measured: 3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Dec 2005 (estimated)
  2. Study startDec 2005
  3. Primary completionJun 2009
  4. Study completionJun 2009

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
37 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00263458
Sponsor's protocol ID
H97HA03799
Acronym
BHIVES-SF
Status last verified
Sep 2011
First submitted
6 Dec 2005
Last updated
12 Sep 2011
Results posted
No
Data monitoring committee
Yes

Publications

  • Korthuis PT, Fiellin DA, Fu R, Lum PJ, Altice FL, Sohler N, Tozzi MJ, Asch SM, Botsko M, Fishl M, Flanigan TP, Boverman J, McCarty D; BHIVES Collaborative. Improving adherence to HIV quality of care indicators in persons with opioid dependence: the role of buprenorphine. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1(Suppl 1):S83-90. doi: 10.1097/QAI.0b013e31820bc9a5.

    PubMed 21317600
  • Sullivan LE, Botsko M, Cunningham CO, O'Connor PG, Hersh D, Mitty J, Lum PJ, Schottenfeld RS, Fiellin DA; BHIVES Collaborative. The impact of cocaine use on outcomes in HIV-infected patients receiving buprenorphine/naloxone. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1(Suppl 1):S54-61. doi: 10.1097/QAI.0b013e3182097576.

    PubMed 21317595
  • Fiellin DA, Weiss L, Botsko M, Egan JE, Altice FL, Bazerman LB, Chaudhry A, Cunningham CO, Gourevitch MN, Lum PJ, Sullivan LE, Schottenfeld RS, O'Connor PG; BHIVES Collaborative. Drug treatment outcomes among HIV-infected opioid-dependent patients receiving buprenorphine/naloxone. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1(0 1):S33-8. doi: 10.1097/QAI.0b013e3182097537.

    PubMed 21317592
  • Altice FL, Bruce RD, Lucas GM, Lum PJ, Korthuis PT, Flanigan TP, Cunningham CO, Sullivan LE, Vergara-Rodriguez P, Fiellin DA, Cajina A, Botsko M, Nandi V, Gourevitch MN, Finkelstein R; BHIVES Collaborative. HIV treatment outcomes among HIV-infected, opioid-dependent patients receiving buprenorphine/naloxone treatment within HIV clinical care settings: results from a multisite study. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1(Suppl 1):S22-32. doi: 10.1097/QAI.0b013e318209751e.

    PubMed 21317590
  • Vergara-Rodriguez P, Tozzi MJ, Botsko M, Nandi V, Altice F, Egan JE, O'Connor PG, Sullivan LE, Fiellin DA; BHIVES Collaborative. Hepatic safety and lack of antiretroviral interactions with buprenorphine/naloxone in HIV-infected opioid-dependent patients. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1:S62-7. doi: 10.1097/QAI.0b013e31820a820f.

    PubMed 21317596
  • Weiss L, Netherland J, Egan JE, Flanigan TP, Fiellin DA, Finkelstein R, Altice FL; BHIVES Collaborative. Integration of buprenorphine/naloxone treatment into HIV clinical care: lessons from the BHIVES collaborative. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1:S68-75. doi: 10.1097/QAI.0b013e31820a8226.

    PubMed 21317597
  • Finkelstein R, Netherland J, Sylla L, Gourevitch MN, Cajina A, Cheever L; BHIVES Collaborative. Policy implications of integrating buprenorphine/naloxone treatment and HIV care. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1:S98-S104. doi: 10.1097/QAI.0b013e31820a9a97.

    PubMed 21317602
  • Chaudhry AA, Botsko M, Weiss L, Egan JE, Mitty J, Estrada B, Lucas GM, Woodson T, Flanigan TP, Fiellin DA; BHIVES Collaborative. Participant characteristics and HIV risk behaviors among individuals entering integrated buprenorphine/naloxone and HIV care. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1:S14-21. doi: 10.1097/QAI.0b013e318209d3b9.

    PubMed 21317589
  • Weiss L, Egan JE, Botsko M, Netherland J, Fiellin DA, Finkelstein R. The BHIVES collaborative: organization and evaluation of a multisite demonstration of integrated buprenorphine/naloxone and HIV treatment. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1:S7-13. doi: 10.1097/QAI.0b013e3182097426.

    PubMed 21317598
  • Cheever LW, Kresina TF, Cajina A, Lubran R. A model federal collaborative to increase patient access to buprenorphine treatment in HIV primary care. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1:S3-6. doi: 10.1097/QAI.0b013e318209740f.

    PubMed 21317591
  • Friedland G, Vlahov D. Integration of buprenorphine for substance-abuse treatment by HIV care providers. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1:S1-2. doi: 10.1097/QAI.0b013e31820bc9ba. No abstract available.

    PubMed 21317588

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Integrated office-based buprenorphine treatment for opioid dependence in an HIV primary care setting in people with HIV and Buprenorphine, run by University of California, San Francisco at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Sep 2011. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Substance use outcomes at 0, 1, 3, 6, 9 and 12 months. (time frame: 0, 1, 3, 6, 9 and 12 months.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00263458, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Sep 2011.

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