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Am J Addict. 2012 Jan-Feb;21(1):55-62. doi: 10.1111/j.1521-0391.2011.00186.x. Epub 2011 Nov 18.
Opioid dependence (OD), often characterized as a chronic relapsing disorder, affects millions of people worldwide. The purpose of this study was to examine the effect of compliance with buprenorphine on reducing relapse among a sample of patients in treatment for OD. Patients new to buprenorphine (N = 703) completed the Addiction Severity Index (ASI) at baseline, and at 1, 2, and 3 months postbaseline. The ASI is a semistructured interview designed to measure problem severity in seven functional areas known to be affected by alcohol and drug dependence. Compliance was defined as taking buprenorphine medication on at least 22 of the past 28 days (80%), while relapse classification was based on resumed use of opioids during the follow-up period (months 2 and 3). Relapse was regressed onto demographic indicators, baseline ASI composite scores, and compliance with buprenorphine. Noncompliant patients were over 10 times more likely to relapse than those who were compliant (exp β= 10.55; p < .001). Neither demographics nor baseline ASI composite scores were predictive of relapse (p's > .05). Compliance with medication-assisted treatment supports abstinence, essential for patient recovery. Understanding the factors that drive treatment compliance and noncompliance may assist providers in supporting patient compliance and recovery.
阿片类药物依赖（OD），通常表现为一种慢性复发性疾病，影响着全球数百万人。本研究的目的是检验阿片类药物依赖患者接受丁丙诺啡治疗的依从性对降低复吸的影响。新接受丁丙诺啡治疗的患者（N=703）在基线时、基线后 1、2 和 3 个月完成成瘾严重程度指数（ASI）评估。ASI 是一种半结构化访谈，旨在衡量受酒精和药物依赖影响的七个功能领域的严重程度。依从性定义为在过去 28 天内至少服用 22 天丁丙诺啡药物（80%），而复发分类则基于随访期间（第 2 和第 3 个月）重新使用阿片类药物。将复发情况回归到人口统计学指标、基线 ASI 综合评分和丁丙诺啡的依从性上。不依从的患者比依从的患者复发的可能性高出 10 倍以上（expβ=10.55；p<0.001）。人口统计学和基线 ASI 综合评分都不能预测复发（p 值>0.05）。药物辅助治疗的依从性支持患者戒除毒瘾，这是患者康复的关键。了解影响治疗依从性和不依从性的因素可能有助于提供者支持患者的依从性和康复。
