Kapuganti Amber, Turner Traci, Thomas Christopher J
Clinical Pharmacist, Outpatient Mental Health Clinic, Department of Veterans Affairs Medical Center, Chillicothe, Ohio,
Clinical Pharmacist, Primary Care Mental Health Integration, Department of Veterans Affairs Medical Center, Chillicothe, Ohio.
Ment Health Clin. 2018 Mar 23;7(6):271-275. doi: 10.9740/mhc.2017.11.271. eCollection 2017 Nov.
This retrospective cohort study evaluated effects of buprenorphine/naloxone dose and concomitant use of selected sedating medications on treatment outcomes in patients with opioid use disorder.
Patients enrolled in the buprenorphine/naloxone clinic at the study institution from 2009 until April 2013 were included. There were no exclusion criteria. Part 1 assessed treatment failure within 6 months and time to treatment failure with buprenorphine doses >8 mg and ≤8 mg. Part 2 assessed for treatment failure within 6 months and time to treatment failure with use of selected sedating medications. Sedating medications were cyproheptadine, hydroxyzine, quetiapine, and trazodone. Treatment failure was defined as documentation of illicit opioid use per patient report, urine drug screen showing opioid use, or patient lost to follow-up.
There were 132 patients included in this study, but 163 separate encounters due to multiple enrollments. Treatment failure was experienced within 6 months 51 times a patient was prescribed ≤8 mg (66.2%) and 26 times a patient was prescribed >8 mg (33.8%) ( = .0005). Average time to treatment failure was 5.1 months with ≤8 mg and 8.4 months with >8 mg. The 48% of patients who received sedating medications did not demonstrate any significant differences in treatment response at 6 months ( = .2746) or time to treatment failure ( = .2209).
Doses of buprenorphine/naloxone >8 mg demonstrated better treatment response and prolonged time to treatment failure. Concomitant sedating medications did not have a statistically significant effect on treatment response or time to treatment failure.
这项回顾性队列研究评估了丁丙诺啡/纳洛酮剂量以及同时使用某些镇静药物对阿片类物质使用障碍患者治疗结果的影响。
纳入2009年至2013年4月在研究机构的丁丙诺啡/纳洛酮诊所登记的患者。没有排除标准。第一部分评估6个月内的治疗失败情况以及丁丙诺啡剂量>8毫克和≤8毫克时的治疗失败时间。第二部分评估6个月内的治疗失败情况以及使用某些镇静药物时的治疗失败时间。镇静药物为赛庚啶、羟嗪、喹硫平和曲唑酮。治疗失败定义为根据患者报告记录的非法阿片类物质使用、尿液药物筛查显示阿片类物质使用或患者失访。
本研究纳入了132名患者，但由于多次登记，共有163次单独就诊。当患者被处方≤8毫克时，6个月内经历治疗失败51次（66.2%），当患者被处方>8毫克时，6个月内经历治疗失败26次（33.8%）（P = 0.0005）。≤8毫克时治疗失败的平均时间为5.1个月，>8毫克时为8.4个月。接受镇静药物治疗的48%的患者在6个月时的治疗反应（P = 0.2746）或治疗失败时间（P = 0.2209）没有任何显著差异。
丁丙诺啡/纳洛酮剂量>8毫克显示出更好的治疗反应和更长的治疗失败时间。同时使用镇静药物对治疗反应或治疗失败时间没有统计学上的显著影响。
