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两项大麻使用障碍治疗的随机对照试验中的主要结局。

Primary outcomes in two randomized controlled trials of treatments for cannabis use disorders.

机构信息

Yale University School of Medicine, Department of Psychiatry, One Long Wharf Drive, Box 18, New Haven, CT 06511, USA.

出版信息

Drug Alcohol Depend. 2011 Nov 1;118(2-3):408-16. doi: 10.1016/j.drugalcdep.2011.04.021. Epub 2011 May 28.

Abstract

BACKGROUND

While several randomized controlled trials evaluating a range of treatments for cannabis use disorders have appeared in recent years, these have been marked by inconsistency in selection of primary outcomes, making it difficult to compare outcomes across studies.

METHOD

With the aim of identifying meaningful and reliable outcome domains in treatment studies of cannabis use disorders, we evaluated multiple indicators of marijuana use, marijuana problems, and psychosocial functioning from two independent randomized controlled trials of behavioral treatments for cannabis use disorders (Ns=450 and 136).

RESULTS

Confirmatory factor analysis indicated that the best-fitting model of outcomes in both trials encompassed three distinct factors: frequency of marijuana use, severity of marijuana use, and psychosocial functioning. In both trials, frequency of marijuana use and longest period of abstinence during treatment were most strongly associated with outcome during follow-up. Using two categorical definitions of "clinically significant improvement," individuals who demonstrated improvement differed on most end-of-treatment and long-term outcomes from those who did not improve.

CONCLUSIONS

Results may guide future randomized controlled trials of treatments for cannabis use disorders in the collection of relevant end-of-treatment outcomes and encourage consistency in the reporting of outcomes across trials.

摘要

背景

近年来,出现了几项评估大麻使用障碍各种治疗方法的随机对照试验,但这些试验在主要结局的选择上存在不一致性,使得难以在研究之间进行结果比较。

方法

为了确定大麻使用障碍治疗研究中具有意义和可靠的结局领域,我们评估了两项独立的大麻使用障碍行为治疗的随机对照试验(n=450 和 136)中多项大麻使用、大麻问题和心理社会功能的指标。

结果

验证性因子分析表明,两项试验中最适合的结局模型都包含三个不同的因素:大麻使用频率、大麻使用严重程度和心理社会功能。在两项试验中,大麻使用频率和治疗期间最长的禁欲期与随访期间的结果最密切相关。使用两种“临床显著改善”的分类定义,与未改善的个体相比,表现出改善的个体在治疗结束时和长期的大多数结局上存在差异。

结论

研究结果可能为大麻使用障碍治疗的未来随机对照试验提供有关治疗结束时结局的信息,并鼓励试验之间的结果报告保持一致性。

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