Brandt Laura, Unger Annemarie, Moser Laura, Fischer Gabriele, Jagsch Reinhold
Center for Public Health, Medical University of Vienna, Vienna, Austria.
Eur Addict Res. 2016;22(1):36-51. doi: 10.1159/000432395. Epub 2015 Aug 29.
The aim of this exploratory analysis of European Quality Audit of Opioid Treatment data was to identify areas of improvement for current opioid maintenance treatment (OMT) approaches.
Factors facilitating treatment entry, retention and refusal were compared between 8 European countries and between OMT patient (OMT-P) and active opioid user (AOU) sample groups. Both groups were divided into those who had never had OMT before (un-experienced OMT-P (n = 573) and AOU (n = 360)) and those who had been maintained at least once prior to this investigation (experienced OMT-P (n = 746) and AOU (n = 377)).
The European comparison showed that motives for starting OMT vary distinctly between countries (p ≤ 0.001). Transnationally, experienced AOU reported concerns about their ability to follow treatment rules and negative treatment experiences as decisive reasons for staying out of OMT. Greater flexibility, less pressure to reduce their treatment dose and greater treatment structure were ranked significantly higher by experienced compared to un-experienced OMT-P as factors that might facilitate treatment retention (p ≤ 0.05).
Increasing awareness of potential shortcomings of OMT delivery systems is crucial to optimally match treatment approaches to patient needs and also to reduce the considerable economic burden of addiction to society.
本项对欧洲阿片类药物治疗质量审计数据的探索性分析旨在确定当前阿片类药物维持治疗（OMT）方法的改进领域。
比较了8个欧洲国家之间以及OMT患者（OMT-P）和活跃阿片类药物使用者（AOU）样本组之间促进治疗进入、维持和拒绝的因素。两组都分为之前从未接受过OMT的人群（无经验的OMT-P（n = 573）和AOU（n = 360））以及在本次调查之前至少接受过一次维持治疗的人群（有经验的OMT-P（n = 746）和AOU（n = 377））。
欧洲范围内的比较表明，开始OMT的动机在不同国家之间存在明显差异（p≤0.001）。在跨国层面，有经验的AOU报告称，担心自己遵守治疗规则的能力以及负面治疗经历是不接受OMT的决定性原因。与无经验的OMT-P相比，有经验的OMT-P将更大的灵活性、更低的减少治疗剂量的压力以及更完善的治疗结构列为可能促进治疗维持的因素，且排名显著更高（p≤0.05）。
提高对OMT给药系统潜在缺点的认识对于使治疗方法与患者需求实现最佳匹配以及减轻成瘾对社会造成的巨大经济负担至关重要。
