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描述治疗过程中大麻使用减少和功能变化的特征:新临床终点的初步步骤。

Characterizing cannabis use reduction and change in functioning during treatment: Initial steps on the path to new clinical endpoints.

机构信息

Center for Technology and Behavioral Health.

Advocates for Human Potential, Inc.

出版信息

Psychol Addict Behav. 2022 Aug;36(5):515-525. doi: 10.1037/adb0000817. Epub 2022 Jan 27.

Abstract

Reduction-based cannabis use endpoints are needed to better evaluate treatments for cannabis use disorder (CUD). This exploratory, secondary analysis aimed to characterize cannabis frequency and quantity reduction patterns and corresponding changes in psychosocial functioning during treatment. We analyzed 16 weeks (4 prerandomization, 12 postrandomization) of data ( = 302) from both arms of a randomized clinical trial assessing pharmacotherapy for CUD. Cannabis consumption pattern classes were extracted with latent profile modeling using self-reported (a) past-week days used (i.e., frequency) and (b) past-week average grams used per using day (i.e., quantity). Changes in mean Marijuana Problem Scale (MPS) and Hospital Anxiety and Depression Scale (HADS) scores were examined among classes. Urine cannabinoid levels were examined in relation to self-reported consumption as a validity check. Two-, three-, four-, and five-class solutions each provided potentially useful conceptualizations of associations between frequency and quantity. Regardless of solution, reductions in MPS scores varied in magnitude across classes and closely tracked class-specific reductions in consumption (e.g., larger MPS reduction corresponded to larger frequency/quantity reductions). Changes in HADS scores were less pronounced and less consistent with consumption patterns. Urine cannabinoid levels closely matched class-specific self-reported consumption frequency. Findings illustrate that frequency and quantity can be used in tandem within mixture model frameworks to summarize heterogeneous cannabis use reduction patterns that may correspond to improved psychosocial functioning. Going forward, similar analytic strategies applied to alternative metrics of cannabis consumption may facilitate construction of useful reduction-based clinical endpoints. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

需要基于减少的大麻使用终点来更好地评估大麻使用障碍 (CUD) 的治疗方法。本探索性的二次分析旨在描述治疗期间大麻使用频率和数量减少的模式以及相应的心理社会功能变化。我们分析了评估治疗 CUD 的药物治疗的随机临床试验的前 16 周(4 周随机分组前,12 周随机分组后)的数据(=302)。使用潜在剖面建模从自我报告的(a)过去一周使用的天数(即频率)和(b)过去一周每天使用的平均克数(即数量)中提取大麻消费模式类别。检查了班级之间平均大麻问题量表(MPS)和医院焦虑和抑郁量表(HADS)得分的变化。检查了尿中大麻素水平与自我报告消费的关系,作为有效性检查。二、三、四和五类解决方案各自提供了频率和数量之间关联的有用概念化。无论解决方案如何,MPS 分数的降低幅度在各个类别中都有所不同,并且与特定类别的消费减少密切相关(例如,更大的 MPS 减少对应于更大的频率/数量减少)。HADS 得分的变化不那么明显,与消费模式的一致性也不高。尿液大麻素水平与特定类别自我报告的消费频率密切匹配。研究结果表明,在混合模型框架内,频率和数量可以一起使用,以总结可能对应于改善心理社会功能的异质大麻使用减少模式。展望未来,应用于替代大麻消费指标的类似分析策略可能有助于构建有用的基于减少的临床终点。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。

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