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丁丙诺啡治疗后生活质量的变化:与治疗依从性和非法阿片类药物使用的关系。

Changes in Quality of Life following Buprenorphine Treatment: Relationship with Treatment Retention and Illicit Opioid Use.

作者信息

Mitchell Shannon Gwin, Gryczynski Jan, Schwartz Robert P, Myers C Patrick, O'Grady Kevin E, Olsen Yngvild K, Jaffe Jerome H

机构信息

a Senior Research Scientist , Friends Research Institute , Baltimore , MD.

出版信息

J Psychoactive Drugs. 2015 Apr-Jun;47(2):149-57. doi: 10.1080/02791072.2015.1014948.

Abstract

Studies of substance abuse treatment outcomes that give priority to cessation of all drug use may obscure other tangible benefits of treatment that are important to patients. The aim of this study was to examine the association between changes in quality of life (QoL) and: (1) retention in treatment; and (2) opioid use as measured by self-report and urine testing. Participants were 300 African American men and women starting outpatient buprenorphine treatment. Participants completed assessments at baseline, three and six months consisting of the World Health Organization's Quality of Life brief scale, Addiction Severity Index, and urine testing for opioids. There were statistically significant increases over time across all four QoL domains: physical, psychological, environmental, and social. Self-reported frequency of opioid use was negatively associated with psychological QoL, but opioid urine test results were not significantly associated with any QoL domains. Continued treatment enrollment was significantly associated with higher psychological QoL and environmental QoL. Patients entering buprenorphine treatment experience improvements in QoL, which are amplified for patients who remain in treatment. Point-prevalence opiate urine test results obtained at each assessment were not associated with any of the QoL domains and may not accurately reflect improvements perceived by patients receiving buprenorphine treatment.

摘要

将所有药物使用的戒断作为首要考量的药物滥用治疗效果研究,可能会掩盖治疗对患者而言其他重要的实际益处。本研究的目的是检验生活质量(QoL)变化与以下两方面之间的关联:(1)治疗留存率;(2)通过自我报告和尿液检测衡量的阿片类药物使用情况。研究参与者为300名开始接受门诊丁丙诺啡治疗的非裔美国男性和女性。参与者在基线、三个月和六个月时完成评估,评估内容包括世界卫生组织生活质量简表、成瘾严重程度指数以及阿片类药物尿液检测。在所有四个生活质量领域(身体、心理、环境和社会),随着时间推移均有统计学上的显著提高。自我报告的阿片类药物使用频率与心理生活质量呈负相关,但阿片类药物尿液检测结果与任何生活质量领域均无显著关联。持续参与治疗与更高的心理生活质量和环境生活质量显著相关。接受丁丙诺啡治疗的患者生活质量有所改善,对于持续接受治疗的患者,这种改善更为明显。每次评估时获得的即时患病率阿片类药物尿液检测结果与任何生活质量领域均无关联,可能无法准确反映接受丁丙诺啡治疗的患者所感知到的改善情况。

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