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家族对患有阿片类药物使用障碍的家庭成员的适当治疗类型和目标的看法。

Familial perceptions of appropriate treatment types and goals for a family member who has opioid use disorder.

机构信息

Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Drug Alcohol Depend. 2021 Apr 1;221:108649. doi: 10.1016/j.drugalcdep.2021.108649. Epub 2021 Feb 22.

Abstract

BACKGROUND

Despite effective, evidence-based medications for opioid use disorder (MOUD), these treatments remain underutilized. This may be due to multiple reasons. Family members may impact patient decision-making when choosing an opioid use disorder (OUD) treatment. While there has been work on patient preferences and attitudes towards opioid use disorder (OUD) treatment, to date, there has been minimal work assessing the attitudes of family member towards OUD treatment and recovery.

METHODS

Participants were ≥ 18 years of age and endorsed having a first-degree family member with past-year treatment for OUD. Participants were recruited via online crowdsourcing and were asked a number of questions regarding their desired outcomes for OUD treatment, and their familiarity, approval, and perceived effectiveness of various OUD treatment options.

RESULTS

The most commonly reported desired treatment outcome (50 %) was for family members to never use any kind of opioid, including maintenance therapies or opioid analgesics. Mean familiarity ratings for MOUD (rated 0-100) were relatively low, with naltrexone being the least familiar (32.3). Among those who endorsed a familiarity rating of at least 30 for a given treatment, mean approval and effectiveness ratings were relatively low-buprenorphine (approve 55.1; effective 54.1), methadone (approve 51.9; effective 49.3), naltrexone (approve 61.6; effective 55.9). These were lower than approval and effectiveness ratings for all non-MOUD treatments queried.

CONCLUSIONS

These findings highlight a need for clinicians and researchers to engage with family members' regarding their preferences and understanding of treatment, and to better understand how this might impact patient engagement with treatment.

摘要

背景

尽管有针对阿片类药物使用障碍(MOUD)的有效循证药物,但这些治疗方法仍未得到充分利用。这可能有多种原因。在选择阿片类药物使用障碍(OUD)治疗方法时,家庭成员可能会影响患者的决策。虽然已经有关于患者对 OUD 治疗的偏好和态度的研究,但迄今为止,评估家庭成员对 OUD 治疗和康复的态度的工作还很少。

方法

参与者年龄在 18 岁及以上,并承认有一级亲属在过去一年中接受过 OUD 治疗。参与者通过在线众包招募,并被问及一系列问题,涉及他们对 OUD 治疗的期望结果,以及他们对各种 OUD 治疗选择的熟悉程度、认可程度和感知效果。

结果

报告的最常见期望治疗结果(50%)是希望家庭成员永远不再使用任何类型的阿片类药物,包括维持治疗或阿片类镇痛药。MOUD 的平均熟悉度评分(评分范围为 0-100)相对较低,纳曲酮的熟悉度最低(32.3)。在那些对特定治疗的熟悉度评分至少为 30 的人中,平均认可和有效评分相对较低-丁丙诺啡(认可 55.1%;有效 54.1%)、美沙酮(认可 51.9%;有效 49.3%)、纳曲酮(认可 61.6%;有效 55.9%)。这些低于所有非 MOUD 治疗方法的认可和有效评分。

结论

这些发现强调了临床医生和研究人员需要与家庭成员就他们对治疗的偏好和理解进行沟通,并更好地了解这如何影响患者对治疗的参与度。

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