Weinstein Zoe M, Cheng Debbie M, Quinn Emily, Hui David, Kim Hyunjoong, Gryczynski Gabriela, Samet Jeffrey H
Boston University School of Medicine/Boston Medical Center, Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education (CARE) Unit, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, United States.
Boston University School of Public Health, Department of Biostatistics, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118, United States.
Drug Alcohol Depend. 2017 Jan 1;170:9-16. doi: 10.1016/j.drugalcdep.2016.10.039. Epub 2016 Nov 5.
The prevalence of psychoactive medications (PAMs) use in patients enrolled in Office Based Opioid Treatment (OBOT) and its association with engagement in this care is largely unknown.
To describe the use of PAMs, including those medications with emerging evidence of misuse ("emerging PAMs" - gabapentin, clonidine and promethazine) among patients on buprenorphine, and its association with disengagement from OBOT.
This is a retrospective cohort study of adults on buprenorphine from January 2002 to February 2014. The association between use of PAMs and 6-month disengagement from OBOT was examined using multivariable logistic regression models. A secondary analysis exploring time-to-disengagement was conducted using Cox regression models.
At OBOT entry, 43% of patients (562/1308) were prescribed any PAM; including 17% (223/1308) on an emerging PAM. In separate adjusted analyses, neither the presence of any PAM (adjusted odds ratio [AOR] 1.07, 95% CI [0.78, 1.46]) nor an emerging PAM (AOR 1.28 [0.95, 1.74]) was significantly associated with 6-month disengagement. The results were similar for the Cox model (any PAM (adjusted hazard ratio [AHR] 1.16, 95% CI [1.00, 1.36]), emerging PAM (AHR 1.18 [0.98, 1.41])). Exploratory analyses suggested gabapentin (AHR 1.30 [1.05-1.62]) and clonidine (AHR 1.33 [1.01-1.73]) specifically, may be associated with an overall shorter time to disengagement.
Psychoactive medication use is common among patients in buprenorphine treatment. No significant association was found between the presence of any psychoactive medications, including medications with emerging evidence of misuse, and 6-month disengagement from buprenorphine treatment.
在接受门诊阿片类药物治疗（OBOT）的患者中，精神活性药物（PAMs）的使用情况及其与接受该治疗的关联在很大程度上尚不清楚。
描述丁丙诺啡治疗患者中PAMs的使用情况，包括那些有新出现的滥用证据的药物（“新出现的PAMs”——加巴喷丁、可乐定和异丙嗪），以及其与退出OBOT治疗的关联。
这是一项对2002年1月至2014年2月期间使用丁丙诺啡的成年人进行的回顾性队列研究。使用多变量逻辑回归模型检验PAMs的使用与6个月内退出OBOT治疗之间的关联。使用Cox回归模型进行了一项探索退出时间的二次分析。
在开始OBOT治疗时，43%的患者（562/1308）被开具了任何一种PAM；其中17%（223/1308）使用了新出现的PAM。在单独的校正分析中，使用任何一种PAM（校正比值比[AOR]为1.07，95%置信区间[CI][0.78, 1.46]）和使用新出现的PAM（AOR为1.28[0.95, 1.74]）与6个月内退出治疗均无显著关联。Cox模型的结果相似（使用任何一种PAM（校正风险比[AHR]为1.16，95%CI[1.00, 1.36]），使用新出现的PAM（AHR为1.18[0.98, 1.41]））。探索性分析表明，特别是加巴喷丁（AHR为1.30[1.05 - 1.62]）和可乐定（AHR为1.33[1.01 - 1.73]）可能与总体较短的退出时间相关。
在丁丙诺啡治疗的患者中，精神活性药物的使用很常见。未发现任何精神活性药物（包括有新出现的滥用证据的药物）的使用与丁丙诺啡治疗6个月内退出之间存在显著关联。
