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住院的阿片类药物依赖患者:探索丁丙诺啡治疗开始及出院后持续治疗的预测因素。

Hospitalized opioid-dependent patients: Exploring predictors of buprenorphine treatment entry and retention after discharge.

作者信息

Lee Christina S, Liebschutz Jane M, Anderson Bradley J, Stein Michael D

机构信息

Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts.

Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts.

出版信息

Am J Addict. 2017 Oct;26(7):667-672. doi: 10.1111/ajad.12533. Epub 2017 Mar 21.

Abstract

OBJECTIVES

Few studies have explored predictors of entry into and retention in buprenorphine treatment following linkage from an acute medical hospitalization.

METHODS

This secondary analysis of a completed clinical trial focuses on medically hospitalized, opioid-dependent patients (n = 72) who were randomized to an intervention including buprenorphine induction and dose stabilization during hospitalization followed by post-discharge transition to office-based buprenorphine treatment (OBOT). Predictors included demographics, days hospitalized, prior buprenorphine/methadone treatment, PTSD symptoms, social support, and readiness for drug use cessation. Outcome variables were treatment entry and retention (number of days in OBOT).

RESULTS

Previous buprenorphine treatment, more days hospitalized, and higher PTSD symptoms predicted OBOT entry. Prior treatment, older age, and non-minority status were associated with a higher mean number of days in OBOT.

CONCLUSIONS

OBOT may appeal to patients who have tried buprenorphine in other settings. Linking hospitalized patients to OBOT may improve utilization of addiction treatment.

SCIENTIFIC SIGNIFICANCE

Prior substance treatment, longer hospital stay, and mental health should be examined in future linkage studies. (Am J Addict 2017;26:667-672).

摘要

目的

很少有研究探讨急性医学住院后进入丁丙诺啡治疗并持续接受该治疗的预测因素。

方法

这项对一项已完成临床试验的二次分析聚焦于因医学原因住院的阿片类药物依赖患者(n = 72),这些患者被随机分配至一种干预措施,包括住院期间进行丁丙诺啡诱导和剂量稳定,出院后过渡至门诊丁丙诺啡治疗(OBOT)。预测因素包括人口统计学特征、住院天数、先前的丁丙诺啡/美沙酮治疗、创伤后应激障碍(PTSD)症状、社会支持以及戒毒意愿。结局变量为治疗进入情况和持续时间(OBOT治疗天数)。

结果

先前接受过丁丙诺啡治疗、住院天数更多以及PTSD症状更严重可预测进入OBOT治疗。先前治疗、年龄较大和非少数族裔身份与OBOT治疗的平均天数较多相关。

结论

OBOT可能对在其他环境中尝试过丁丙诺啡的患者有吸引力。将住院患者与OBOT联系起来可能会提高成瘾治疗的利用率。

科学意义

在未来的联系研究中应考察先前的物质治疗、较长的住院时间和心理健康情况。(《美国成瘾杂志》2017年;26:667 - 672)

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