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在住院环境中,寻求从丁丙诺啡向纳曲酮缓释片转换的阿片类使用障碍个体的特征和治疗偏好。

Characteristics and treatment preferences of individuals with opioid use disorder seeking to transition from buprenorphine to extended-release naltrexone in a residential setting.

机构信息

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.

Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

出版信息

Am J Addict. 2022 Mar;31(2):142-147. doi: 10.1111/ajad.13264. Epub 2022 Feb 9.

DOI:10.1111/ajad.13264
PMID:35137481
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9304146/
Abstract

BACKGROUND AND OBJECTIVES

Treatment for individuals receiving medication for opioid use disorder (MOUD) should follow an informed patient-centered approach. To better support patient autonomy in the decision-making process, clinicians should be aware of patient preferences and be prepared to educate and assist patients in transitioning from one MOUD to another, when clinically indicated. This posthoc analysis describes the characteristics of clinical trial participants (NCT02696434) with a history of opioid use disorder (OUD) seeking to transition from buprenorphine (BUP) to extended-release naltrexone (XR-NTX).

METHODS

The posthoc analysis included adults with OUD currently receiving BUP (≤8 mg/day) and seeking transition to XR-NTX (N = 101) in a residential setting. Baseline participant characteristics and OUD treatment history were reviewed. All patients completed a screening questionnaire that asked about their reasons for seeking transition to XR-NTX and for choosing BUP.

RESULTS

The most common reasons for initiating a transition to XR-NTX were "Seeking to be opioid-free" (63.4%) and "Tired of daily pill taking" (25.7%). Positive predictors of transition included a more extensive BUP treatment history and a history of prescription opioid abuse. Most participants stated they were not aware of XR-NTX as a treatment option when initiating BUP (78.2%).

DISCUSSIONS AND CONCLUSIONS

Patients' reasons for seeking XR-NTX transition, more extensive BUP treatment history, and a history of prescription opioid abuse, may positively predict outcomes.

SCIENTIFIC SIGNIFICANCE

These findings may assist clinicians in optimizing outcomes of the BUP to XR-NTX transition and supporting patients to make better informed MOUD decisions.

摘要

背景和目的

接受阿片类药物使用障碍(MOUD)药物治疗的个体的治疗应遵循知情的以患者为中心的方法。为了更好地支持患者在决策过程中的自主性,临床医生应该了解患者的偏好,并在临床需要时准备好教育和协助患者从一种 MOUD 过渡到另一种 MOUD。本事后分析描述了(NCT02696434)患有阿片类药物使用障碍(OUD)病史的寻求从丁丙诺啡(BUP)过渡到纳曲酮延长释放剂(XR-NTX)的临床试验参与者的特征。

方法

事后分析包括目前正在接受 BUP(≤8mg/天)治疗且寻求在住院环境中过渡到 XR-NTX 的 OUD 成人(N=101)。回顾了基线参与者特征和 OUD 治疗史。所有患者都完成了一份筛查问卷,询问他们寻求过渡到 XR-NTX 的原因以及选择 BUP 的原因。

结果

启动 XR-NTX 过渡的最常见原因是“寻求阿片类药物戒断”(63.4%)和“厌倦每天服药”(25.7%)。过渡的积极预测因素包括更广泛的 BUP 治疗史和处方类阿片滥用史。大多数参与者表示,在开始使用 BUP 时,他们不知道 XR-NTX 是一种治疗选择(78.2%)。

讨论和结论

患者寻求 XR-NTX 过渡的原因、更广泛的 BUP 治疗史和处方类阿片滥用史可能对结局产生积极影响。

科学意义

这些发现可能有助于临床医生优化 BUP 向 XR-NTX 过渡的结局,并支持患者做出更好的 MOUD 决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60c3/9304146/cb8759eaeea5/AJAD-31-142-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60c3/9304146/463edaac4553/AJAD-31-142-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60c3/9304146/873580e32837/AJAD-31-142-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60c3/9304146/cb8759eaeea5/AJAD-31-142-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60c3/9304146/463edaac4553/AJAD-31-142-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60c3/9304146/873580e32837/AJAD-31-142-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/60c3/9304146/cb8759eaeea5/AJAD-31-142-g003.jpg

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本文引用的文献

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Am J Addict. 2020 Jul;29(4):313-322. doi: 10.1111/ajad.13024. Epub 2020 Apr 4.
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Comparing Reasons for Starting and Stopping Methadone, Buprenorphine, and Naltrexone Treatment Among a Sample of White Individuals With Opioid Use Disorder.比较一组患有阿片类药物使用障碍的白人个体开始和停止美沙酮、丁丙诺啡和纳曲酮治疗的原因。
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