Sophie Davis School of Biomedical Education, Community Health and Social Medicine, City College of the City University of New York, NY 10031, USA.
J Subst Abuse Treat. 2010 Mar;38(2):153-9. doi: 10.1016/j.jsat.2009.08.001. Epub 2009 Oct 3.
Recent legislation permits the treatment of opioid-dependent patients with buprenorphine in the primary care setting, opening doors for the development of new treatment models for opioid dependence. We modified national buprenorphine treatment guidelines to emphasize patient self-management by giving patients the opportunity to choose to have buprenorphine inductions at home or the physician's office. We examined whether patients who had home-based inductions achieved greater 30-day retention than patients who had traditional office-based inductions in a study of 115 opioid-dependent patients treated in an inner-city health center. Retention was similar in both groups: 50 (78.1%) in office-based group versus 40 (78.4%) in home-based group, p = .97. Several patient characteristics were associated with choosing office- versus home-based inductions, which likely influenced these results. We conclude that opioid dependence can be successfully managed in the primary care setting. Approaches that encourage patient involvement in treatment for opioid dependence can be beneficial.
最近的立法允许在初级保健环境中使用丁丙诺啡治疗阿片类药物依赖患者，为开发新的阿片类药物依赖治疗模式打开了大门。我们修改了国家丁丙诺啡治疗指南，通过让患者有机会选择在家中或医生办公室进行丁丙诺啡诱导，强调患者自我管理。我们在一项对 115 名在市中心健康中心接受治疗的阿片类药物依赖患者的研究中，考察了在家中进行诱导的患者是否比在传统办公室进行诱导的患者在 30 天内的保留率更高。两组的保留率相似：办公室组为 50 例（78.1%），家庭组为 40 例（78.4%），p =.97。选择办公室和家庭诱导的患者有几个特征不同，这可能影响了这些结果。我们的结论是，阿片类药物依赖可以在初级保健环境中得到成功管理。鼓励患者参与阿片类药物依赖治疗的方法可能是有益的。
