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参与随机临床试验的大麻使用者与其他寻求治疗者有何不同?

Are cannabis users who participate in a randomized clinical trial different from other treatment seekers?

作者信息

Frewen Amie R, Baillie Andrew J, Montebello Mark E

机构信息

Centre for Emotional Health, Psychology Department, Macquarie University, Sydney NSW, Australia.

出版信息

J Subst Abuse Treat. 2009 Apr;36(3):339-44. doi: 10.1016/j.jsat.2008.07.004. Epub 2008 Oct 1.

Abstract

Randomized controlled trials (RCTs) provide the most convincing evidence for clinical questions concerning the efficacy of interventions. When participants in RCTs are characteristically different to those in usual clinical practice, it may be difficult to generalize findings. This study compares profiles taken from a centralized intake process for those presenting with cannabis as their main drug, which were then separated into three categories, (a) those who were offered a specialist assessment for cannabis dependence over the phone but did not attend their appointment, (b) those who presented for their initial appointment, and c) those attending and subsequently recruited into an RCT. To explore whether issues such as severity of cannabis use and co-occurring disorders acted as a barrier to attending treatment or to inclusion in an RCT, we examined basic triage information. Results indicated that there were no statistically significant differences on selected characteristics between groups, suggesting that RCT participants were representative of treatment seekers, and that the filtering that occurs between those who make phone contact with professional services and those who present to treatment are not necessarily due to presence of patient characteristics such as coexisting medical, psychological issues, or severity of their cannabis use.

摘要

随机对照试验(RCT)为有关干预措施疗效的临床问题提供了最具说服力的证据。当随机对照试验的参与者与常规临床实践中的参与者有显著差异时,可能难以将研究结果推广。本研究比较了以大麻为主要毒品的患者在集中入院过程中的特征,然后将其分为三类:(a)通过电话获得大麻依赖专家评估但未赴约的患者;(b)前来进行初次预约的患者;(c)参加并随后被纳入随机对照试验的患者。为了探讨大麻使用严重程度和共病等问题是否成为接受治疗或纳入随机对照试验的障碍,我们检查了基本的分诊信息。结果表明,各组在选定特征上没有统计学上的显著差异,这表明随机对照试验的参与者代表了寻求治疗的人群,并且在与专业服务机构进行电话联系的人群和前来接受治疗的人群之间进行筛选,不一定是由于患者存在诸如并存的医疗、心理问题或大麻使用严重程度等特征。

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