Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, 560011, India.
Asian J Psychiatr. 2019 Aug;44:58-60. doi: 10.1016/j.ajp.2019.07.030. Epub 2019 Jul 15.
Opioid substitution therapy is an evidence-based treatment for opioid dependence syndrome. Retention in treatment is a crucial mediator of treatment success. Our study aims to examine factors associated with early treatment non-compliance among patients who are initiated on office-based Buprenorphine Maintenance Treatment (BMT).
This is a prospective observational study conducted among 89 subjects who were initiated on BMT and were followed up to 6 weeks. At baseline, we evaluated subjects using: Mini International Neuropsychiatric Interview Plus, Addiction Severity Index-Lite, Multi-Dimensional Scale of Perceived Social Support, Heroin Craving Questionnaire, and urine toxicological analysis. Treatment adherence for six weeks was noted.
Among Eighty-nine subjects, 57 per cent of the sample reported addiction to pharmaceutical opioids. The mean dose of Buprenorphine was 6.7 mg (SD = 4.1). During follow up 67 per cent (n = 62) patients were adherent to treatment while 33 per cent (n = 27) non-adherent to treatment. The mean dose of buprenorphine in the non-adherent group was significantly lower than the adherent group (4.3 mg and 7.7 mg, respectively, t [87] = 3.8, p < 0.001). A comparison of groups based on the dose of Buprenorphine (6 mg or higher vs lower than 6 mg) revealed that odds of treatment non-adherence were three times higher in patients receiving 6 mg or lesser dose (Odds Ratio = 3.15 [95% CI = 2.0-8.6],χ [1] = 4.75, p = 0.035).
Dose of Buprenorphine prescribed by the treating clinician influences early treatment compliance significantly.
阿片类药物替代疗法是治疗阿片类药物依赖综合征的一种基于证据的治疗方法。治疗保留率是治疗成功的关键中介因素。我们的研究旨在检查开始接受门诊丁丙诺啡维持治疗（BMT）的患者中早期治疗不依从的相关因素。
这是一项在 89 名开始接受 BMT 并随访至 6 周的患者中进行的前瞻性观察研究。在基线时，我们使用以下方法对受试者进行评估：迷你国际神经精神访谈加、成瘾严重程度指数-简化版、多维感知社会支持量表、海洛因渴望问卷和尿液毒理学分析。记录了 6 周的治疗依从性。
在 89 名受试者中，57%的样本报告对药物类阿片成瘾。丁丙诺啡的平均剂量为 6.7mg（SD=4.1）。在随访期间，67%（n=62）的患者对治疗依从，33%（n=27）不依从。不依从组的丁丙诺啡平均剂量明显低于依从组（分别为 4.3mg 和 7.7mg，t[87]=3.8，p<0.001）。根据丁丙诺啡剂量（6mg 或更高与低于 6mg）对组进行比较，发现接受 6mg 或更低剂量的患者治疗不依从的可能性高出三倍（优势比=3.15[95%CI=2.0-8.6]，x²[1]=4.75，p=0.035）。
治疗医生开具的丁丙诺啡剂量显著影响早期治疗依从性。
