Miguel André Q C, Smith Crystal L, Burduli Ekaterina, Roll John M, McPherson Sterling
Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States; Analytics and PsychoPharmacology Laboratory (APPL) and the Program of Excellence in Addiction Research, Washington State University, Spokane, WA, United States; Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil.
Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States; Analytics and PsychoPharmacology Laboratory (APPL) and the Program of Excellence in Addiction Research, Washington State University, Spokane, WA, United States.
J Subst Abuse Treat. 2021 May;124:108291. doi: 10.1016/j.jsat.2021.108291. Epub 2021 Jan 14.
Research has yet to empirically evaluate methamphetamine (MA) use outcome measures commonly used to indicate treatment success. Clinically meaningful outcomes must be associated with long-term functioning in important life domains. This study evaluated the association between different MA use outcomes and long-term life-functioning.
The data that this study used in its secondary analyses were pooled from two treatment trials for MA use disorders (n = 237). The study conducted multiple regression analyses (with multiple imputation for missing data) to determine the association of six within-treatment MA use outcome measures with problem severity in seven life domains and a proxy measure for overall functioning, measured with the Addiction Severity Index (ASI) and assessed at an 8-month follow-up.
The longest duration of abstinence (LDA) outcome achieved the most consistent performance, being associated with better scores in five of eight ASI outcomes (β ranging from -0.203 to -0.291; p < .01). The complete abstinence during treatment demonstrated the poorest performance and was not significantly associated with any of the ASI outcomes. All other MA use outcome measures were significantly (p < .01) associated with at least one ASI outcome.
This study provides empirical support for the use of LDA as a clinically relevant indicator of treatment success for MA use disorders, while also indicating the limitations of using complete abstinence during treatment to determine treatment success. Based on these findings, providers and researchers should use LDA as a primary outcome for MA use disorder treatments and trials.
研究尚未对常用于表明治疗成功的甲基苯丙胺(MA)使用结果指标进行实证评估。具有临床意义的结果必须与重要生活领域的长期功能相关联。本研究评估了不同的MA使用结果与长期生活功能之间的关联。
本研究在二次分析中使用的数据来自两项针对MA使用障碍的治疗试验(n = 237)。该研究进行了多元回归分析(对缺失数据进行多重插补),以确定六项治疗期间MA使用结果指标与七个生活领域的问题严重程度以及用成瘾严重程度指数(ASI)衡量并在8个月随访时评估的整体功能替代指标之间的关联。
最长禁欲期(LDA)结果表现最为一致,与八项ASI结果中的五项得分较好相关(β范围为 -0.203至 -0.291;p <.01)。治疗期间完全禁欲表现最差,与任何ASI结果均无显著关联。所有其他MA使用结果指标均与至少一项ASI结果显著相关(p <.01)。
本研究为将LDA用作MA使用障碍治疗成功的临床相关指标提供了实证支持,同时也指出了使用治疗期间完全禁欲来确定治疗成功的局限性。基于这些发现,医疗服务提供者和研究人员应将LDA用作MA使用障碍治疗和试验的主要结果指标。