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探索药物治疗患者的死亡率:治疗类型与死亡率的关系。

Exploring mortality among drug treatment clients: The relationship between treatment type and mortality.

机构信息

Turning Point, Eastern Health, 54-62 Gertrude Street, Fitzroy 3065, Victoria, Australia; Eastern Health Clinical School, Monash University, Victoria, Australia.

Institute for Social Science Research, University of Queensland, St Lucia, Queensland, Australia.

出版信息

J Subst Abuse Treat. 2017 Nov;82:22-28. doi: 10.1016/j.jsat.2017.09.001. Epub 2017 Sep 5.

Abstract

AIMS

Studies consistently identify substance treatment populations as more likely to die prematurely compared with age-matched general population, with mortality risk higher out-of-treatment than in-treatment. While opioid-using pharmacotherapy cohorts have been studied extensively, less evidence exists regarding effects of other treatment types, and clients in treatment for other drugs. This paper examines mortality during and following treatment across treatment modalities.

METHODS

A retrospective seven-year cohort was utilised to examine mortality during and in the two years following treatment among clients from Victoria, Australia, recorded on the Alcohol and Drug Information Service database by linking with National Death Index. 18,686 clients over a 12-month period were included. Crude (CMRs) and standardised mortality rates (SMRs) were analysed in terms of treatment modality, and time in or out of treatment.

RESULTS

Higher risk of premature death was associated with residential withdrawal as the last type of treatment engagement, while mortality following counselling was significantly lower than all other treatment types in the year post-treatment. Both CMRs and SMRs were significantly higher in-treatment than post-treatment.

CONCLUSION

Better understanding of factors contributing to elevated mortality risk for clients engaged in, and following treatment, is needed to ensure that treatment systems provide optimal outcomes during and after treatment.

摘要

目的

研究一致表明,与年龄匹配的一般人群相比,物质治疗人群更有可能过早死亡,治疗外的死亡率高于治疗中。虽然已经对使用阿片类药物进行药物治疗的队列进行了广泛研究,但关于其他治疗类型和治疗其他药物的客户的影响的证据较少。本文研究了不同治疗方式在治疗期间和治疗后的死亡率。

方法

利用回顾性的七年队列研究,通过与国家死亡索引链接,在澳大利亚维多利亚州的酒精和毒品信息服务数据库中记录的客户中,检查治疗期间和治疗后两年内的死亡率。在 12 个月的时间内纳入了 18686 名客户。根据治疗方式和治疗或治疗外的时间,分析了死亡率(CMRs)和标准化死亡率(SMRs)。

结果

最后一次接受住院戒断治疗的患者过早死亡的风险更高,而治疗后一年接受咨询治疗的患者的死亡率明显低于所有其他治疗类型。治疗中的 CMRs 和 SMRs 均显著高于治疗后。

结论

需要更好地了解导致接受治疗和治疗后客户的死亡率升高的因素,以确保治疗系统在治疗期间和治疗后提供最佳结果。

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