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衰老、长期阿片类药物维持治疗患者的躯体疾病负担大且不明确。

Large and non-specific somatic disease burdens among ageing, long-term opioid maintenance treatment patients.

机构信息

Norwegian Centre for Addiction Research, Institute for Clinical Medicine, University of Oslo, Bygg 45, Ullevål sykehus, Kirkeveien 166, 0450, Oslo, Norway.

Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.

出版信息

Subst Abuse Treat Prev Policy. 2020 Nov 16;15(1):87. doi: 10.1186/s13011-020-00311-4.

Abstract

OBJECTIVES

To describe and explore somatic disease burdens of ageing long-term patients in opioid maintenance treatment (OMT), a unique population emerging in countries offering OMT as a long-term treatment.

METHODS

We used data from the Norwegian Cohort of Patient in Opioid Maintenance Treatment and Other Drug Treatment Study (NorComt). 156 patients enrolled for at least three of the past five years provided data during structured interviews, including on chronic conditions, somatic treatment received, mental distress (SCL-25), and treatment satisfaction. A somatic disease burden was calculated from a list measuring the recent severity of 16 somatic complaints. A hierarchical multiple linear regression analysis identified correlates of somatic disease burden.

RESULTS

Over half of patients reported at least seven somatic complaints. Reported somatic disease burden was associated with higher mental distress, more chronic conditions, fewer years in OMT, and treatment dissatisfaction. Age was unrelated, and there were few gender differences. These five variables explained 43.6% of the variance in disease burden.

CONCLUSION

Long-term OMT patients experience a large range of somatic complaints, and at non-acute levels. As OMT secures longevity for opioid-dependent persons, the clinical focus must be adjusted from acute to chronic care. Providers must address how to optimize health and quality of life while in treatment, as treatment may last for many years.

摘要

目的

描述和探讨接受阿片类药物维持治疗(OMT)的长期患者的躯体疾病负担,这是在提供 OMT 作为长期治疗的国家中出现的一个独特人群。

方法

我们使用了来自挪威阿片类药物维持治疗和其他药物治疗研究(NorComt)的患者队列的数据。156 名至少在过去五年中参加了三次以上的患者在结构化访谈中提供了数据,包括慢性疾病、接受的躯体治疗、精神困扰(SCL-25)和治疗满意度。从衡量 16 种躯体抱怨近期严重程度的列表中计算出躯体疾病负担。层次多重线性回归分析确定了躯体疾病负担的相关因素。

结果

超过一半的患者报告了至少七种躯体抱怨。报告的躯体疾病负担与较高的精神困扰、更多的慢性疾病、较少的 OMT 年限和治疗不满意有关。年龄与疾病负担无关,且性别差异较小。这五个变量解释了疾病负担方差的 43.6%。

结论

长期接受 OMT 的患者经历了广泛的躯体抱怨,且处于非急性水平。随着 OMT 为阿片类药物依赖者延长寿命,临床重点必须从急性护理调整为慢性护理。提供者必须解决如何在治疗期间优化健康和生活质量的问题,因为治疗可能会持续多年。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/486f/7667746/78f8e5ab5e23/13011_2020_311_Fig1_HTML.jpg

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