Parsons Graham, Ragbir Cindy, D'Agnone Oscar, Gibbs Ayana, Littlewood Richard, Hard Bernadette
Turning Point, London, UK.
The OAD Clinic, London, UK.
Subst Abuse Rehabil. 2020 Nov 2;11:41-47. doi: 10.2147/SAR.S266838. eCollection 2020.
Prolonged-release buprenorphine (PRB), administered by weekly or monthly injection, for opioid dependence (OD) treatment offers the potential to address some limitations of oral therapy including stigma, difficulty in achieving consistent appropriate dosing, risk of diversion of medications, risk of overdose, and continuing use of other drugs. Patient-reported outcomes (PRO) and experiences are important in the evaluation of OD therapy success. This work aimed to document PRO during PRB therapy to guide future treatment decision-making.
Qualitative interviews were completed with people on PRB OD treatment. Twenty individuals from four treatment services in England and Wales were asked to participate. A structured interview was developed guided by a person with OD lived experience. Interviews were transcribed, coded and analyzed using iterative categorization.
Fifteen of 20 individuals approached agreed to participate, and 14 completed interviews. The average age of participants was 42 (range 33-54) years, 13 males and 1 woman, the history of problematic opioid use was 14 years (3-25 years), time in treatment was 7 years (1-20 years), and duration on treatment with PRB was 4 months (range 1-8 months). Participants reported treatment experiences leading to coding of 277 unique comments: therapy effectiveness (77% indicated a benefit of, or satisfaction with, PRB therapy, 7% neutral/general, 16% indicated concern or questions about PRB therapy), convenience (81% benefit, 7% neutral/general, 12% concern), and overall satisfaction (81% benefit, 3% neutral/general, 16% concern). Reported benefits include cravings reduction of 10 (71%), self-care improvement of 10 (71%), relationships improvement of 9 (64%), resources management of 6 (43%), positive outlook on life of 12 (86%). Participants reported a range of positive personal experiences; challenges reported included temporary injection discomfort at treatment initiation.
In this small, focused population, there was generally a positive level of treatment satisfaction with PRB. These experiences provide insights to explain potential treatment benefit to others and are useful in guiding therapy choices for others in the future.
通过每周或每月注射给药的长效丁丙诺啡（PRB）用于阿片类药物依赖（OD）治疗，有可能解决口服疗法的一些局限性，包括耻辱感、难以实现持续适当给药、药物转移风险、过量用药风险以及继续使用其他药物的问题。患者报告的结果（PRO）和经历对于评估OD治疗的成功至关重要。这项工作旨在记录PRB治疗期间的PRO，以指导未来的治疗决策。
对接受PRB OD治疗的患者进行了定性访谈。邀请了来自英格兰和威尔士四个治疗机构的20名患者参与。在一名有OD生活经历的人的指导下制定了结构化访谈。访谈进行了转录、编码，并使用迭代分类法进行了分析。
20名被邀请者中有15人同意参与，14人完成了访谈。参与者的平均年龄为42岁（范围33 - 54岁），男性13人，女性1人，有问题的阿片类药物使用史为14年（3 - 25年），治疗时间为7年（1 - 20年），接受PRB治疗的持续时间为4个月（范围1 - 8个月）。参与者报告的治疗经历产生了277条独特的评论编码：治疗效果（77%表示PRB治疗有益或满意，7%中立/一般，16%表示对PRB治疗有担忧或疑问）、便利性（81%有益，7%中立/一般，12%担忧）以及总体满意度（81%有益，3%中立/一般，16%担忧）。报告的益处包括10人（71%）的渴望减少、10人（71%）的自我护理改善、9人（64%）的人际关系改善、6人（43%）的资源管理改善、12人（86%）对生活的积极展望。参与者报告了一系列积极的个人经历；报告的挑战包括治疗开始时暂时的注射不适。
在这个规模较小、针对性较强的人群中，对PRB的治疗满意度总体较高。这些经历为解释对他人潜在的治疗益处提供了见解，并有助于指导未来其他人的治疗选择。
