对患者和医疗服务提供者关于阿片类物质使用障碍治疗药物观点的系统评价。
A systematic review of patients' and providers' perspectives of medications for treatment of opioid use disorder.
作者信息
Cioe Katharine, Biondi Breanne E, Easly Rebecca, Simard Amanda, Zheng Xiao, Springer Sandra A
机构信息
Frank H. Netter MD School of Medicine, 370 Bassett Road, North Haven, CT 06473, United States of America.
Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, United States of America.
出版信息
J Subst Abuse Treat. 2020 Dec;119:108146. doi: 10.1016/j.jsat.2020.108146. Epub 2020 Sep 22.
BACKGROUND
The opioid epidemic is a public health crisis. Medications for opioid use disorder (MOUD) include: 1) buprenorphine, 2) methadone, and 3) extended-release naltrexone (XR-NTX). Research should investigate patients' and providers' perspectives of MOUD since they can influence prescription, retention, and recovery.
METHODS
This systematic review focused on patients' and providers' perceptions of MOUD. The review eligibility criteria included inclusion of the outcome of interest, in English, and involving persons ≥18 years. A PubMed database search yielded 1692 results; we included 152 articles in the final review.
RESULTS
There were 63 articles about buprenorphine, 115 articles about methadone, and 16 about naltrexone. Misinformation and stigma associated with MOUD were common patient themes. Providers reported lack of training and resources as barriers to MOUD.
CONCLUSION
This review suggests that patients have significant misinformation regarding MOUD. Due to the severity of the opioid epidemic, research must consider the effects of patients' and providers' perspectives on treatment for OUD, including the effects on the type of MOUD prescribed, patient retention and adherence, and ultimately the number of patients treated for OUD, which will aid in curbing the opioid epidemic.
背景
阿片类药物流行是一场公共卫生危机。用于治疗阿片类药物使用障碍(MOUD)的药物包括:1)丁丙诺啡,2)美沙酮,以及3)长效纳曲酮(XR-NTX)。研究应调查患者和医疗服务提供者对MOUD的看法,因为它们会影响处方、治疗持续率和康复情况。
方法
本系统评价聚焦于患者和医疗服务提供者对MOUD的认知。评价纳入标准包括纳入感兴趣的结局指标、英文文献,以及纳入年龄≥18岁的人群。在PubMed数据库中检索得到1692条结果;最终纳入152篇文章进行评价。
结果
有63篇关于丁丙诺啡的文章,115篇关于美沙酮的文章,16篇关于纳曲酮的文章。与MOUD相关的错误信息和污名化是常见的患者主题。医疗服务提供者报告称,缺乏培训和资源是MOUD治疗的障碍。
结论
本评价表明,患者对MOUD存在重大错误认知。鉴于阿片类药物流行的严重性,研究必须考虑患者和医疗服务提供者的观点对阿片类药物使用障碍治疗的影响,包括对所开具的MOUD类型、患者治疗持续率和依从性的影响,以及最终接受阿片类药物使用障碍治疗的患者数量,这将有助于遏制阿片类药物流行。
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