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关于阿片类药物维持治疗患者从专门的成瘾性疾病中心转诊至初级保健相关因素的前瞻性研究。

Prospective Study on Factors Associated with Referral of Patients with Opioid Maintenance Therapy from Specialized Addictive Disorders Centers to Primary Care.

作者信息

Guillou-Landreat Morgane, Levassor Philippe, Guerlais Marylène, Sebille Veronique, Victorri-Vigneau Caroline

机构信息

INSERM UMR 1246, SPHERE, Methods in Patient-Centered Outcomes and Health Research, Nantes and Tours Universities, 44000 Nantes, France.

EA 7479 SPURBO, Université Bretagne Occidentale, 29200 Brest, France.

出版信息

Int J Environ Res Public Health. 2021 May 27;18(11):5749. doi: 10.3390/ijerph18115749.

DOI:10.3390/ijerph18115749
PMID:34071908
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8198158/
Abstract

: One of the most important issues for opiate maintenance therapy efficacy is the involvement of primary care physicians (PCPs) in opiate use disorder treatment, especially after referral from specialized units. This study aimed to analyze the progress of subjects in a specialized center and after referral to PCPs. : This study was an observational prospective study. Recruitment took place in a specialized addictive disorder center in western France. All patients were evaluated (sociodemographical data, severity of substance use disorders through the TMSP scale, the quality of life through the TEAQV scale) by physicians during the 5-year-follow up of the study. Analysis focused on four main times during follow-up: entry/last visit into specialized care and into primary care. : 113 patients were included in this study; 93% were receiving methadone and 7% buprenorphine. Ninety (90) were referred to primary care. In primary care follow-up, the probability of the lowest severity score for substance use disorders remained stable over time. : In daily practice, a center specialized in addictive disorders referred OMT management to PCPs for a majority of patients, and benefits regarding substance use disorders severity and quality of life remained stable after referral. Our results need to be confirmed.

摘要

对于阿片类维持治疗疗效而言,最重要的问题之一是初级保健医生(PCP)参与阿片类物质使用障碍的治疗,尤其是在从专科单位转诊之后。本研究旨在分析专科中心的患者以及转诊至初级保健医生处之后的患者进展情况。:本研究为观察性前瞻性研究。招募工作在法国西部一家专门的成瘾障碍中心进行。在该研究的5年随访期间,医生对所有患者进行了评估(社会人口统计学数据、通过TMSP量表评估物质使用障碍的严重程度、通过TEAQV量表评估生活质量)。分析聚焦于随访期间的四个主要时间点:进入专科护理/最后一次就诊以及进入初级保健。:本研究纳入了113名患者;93%接受美沙酮治疗,7%接受丁丙诺啡治疗。其中90名患者被转诊至初级保健。在初级保健随访中,物质使用障碍严重程度最低评分的概率随时间保持稳定。:在日常实践中,一家专门治疗成瘾障碍的中心将大多数患者的阿片类维持治疗管理工作转诊给了初级保健医生,转诊后物质使用障碍严重程度和生活质量方面的益处保持稳定。我们的研究结果有待证实。

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本文引用的文献

1
Retention of patients in opioid substitution treatment: A systematic review.阿片类药物替代治疗中患者的保留情况:系统评价。
PLoS One. 2020 May 14;15(5):e0232086. doi: 10.1371/journal.pone.0232086. eCollection 2020.
2
Primary Care of Opioid use Disorder: The End of "the French Model"?阿片类物质使用障碍的初级保健:“法国模式”的终结?
Eur Addict Res. 2020;26(6):346-354. doi: 10.1159/000506630. Epub 2020 Mar 10.
3
Medications for management of opioid use disorder.阿片类药物使用障碍的药物治疗。
接受阿片类药物治疗的药物使用者如何看待他们的治疗?一项多中心研究。
Harm Reduct J. 2022 Mar 28;19(1):31. doi: 10.1186/s12954-022-00608-6.
Am J Health Syst Pharm. 2019 Jul 18;76(15):1097-1103. doi: 10.1093/ajhp/zxz105.
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Managing opioid use disorder in primary care: PEER simplified guideline.初级保健中阿片类药物使用障碍的管理:PEER简化指南。
Can Fam Physician. 2019 May;65(5):321-330.
5
Barriers to progressing through a methadone maintenance treatment programme: perspectives of the clients in the Mid-West of Ireland's drug and alcohol services.美沙酮维持治疗项目推进过程中的障碍:爱尔兰中西部毒品与酒精服务机构中服务对象的观点
BMC Health Serv Res. 2018 Nov 29;18(1):911. doi: 10.1186/s12913-018-3717-2.
6
Continuous opioid substitution treatment over five years: Heroin use trajectories and outcomes.连续五年的阿片类药物替代治疗:海洛因使用轨迹和结果。
Drug Alcohol Depend. 2018 Jul 1;188:200-208. doi: 10.1016/j.drugalcdep.2018.03.052. Epub 2018 May 16.
7
Integrated Models of Care for Individuals with Opioid Use Disorder: How Do We Prevent HIV and HCV?阿片类物质使用障碍患者的综合护理模式:我们如何预防 HIV 和 HCV?
Curr HIV/AIDS Rep. 2018 Jun;15(3):266-275. doi: 10.1007/s11904-018-0396-x.
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Family Related Factors and Concurrent Heroin Use in Methadone Maintenance Treatment in China.中国美沙酮维持治疗中与家庭相关的因素及海洛因的同时使用情况
Subst Use Misuse. 2018 Aug 24;53(10):1674-1680. doi: 10.1080/10826084.2018.1424913. Epub 2018 Jan 29.
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Recommendations for buprenorphine and methadone therapy in opioid use disorder: a European consensus.阿片类物质使用障碍中丁丙诺啡和美沙酮治疗的建议:一项欧洲共识
Expert Opin Pharmacother. 2017 Dec;18(18):1987-1999. doi: 10.1080/14656566.2017.1409722. Epub 2017 Dec 3.
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Measuring quality of life in opioid-dependent people: a systematic review of assessment instruments.测量阿片类药物依赖者的生活质量:评估工具的系统评价
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