Martin Emily, Maher Hayley, McKeon Gemma, Patterson Sue, Blake Julie, Chen Kai Yang
Metro North Mental Health Service, Brisbane, Queensland, Australia; Faculty of Medicine, University of Queensland, Brisbane, Australia.
Townsville University Hospital, Townsville, Queensland, Australia.
J Subst Abuse Treat. 2022 Aug;139:108776. doi: 10.1016/j.jsat.2022.108776. Epub 2022 Mar 25.
This systematic review synthesizes evidence on both the effects and perspectives of the use of novel long-acting injectable buprenorphine (LAIB) as part of medication-assisted treatment (MAT) and its impact on social determinants of health (SDH), specifically abstinence, accessibility, employment, forensic matters, and gender and social relationships via a framework approach.
The study team searched three databases between January 2010 and June 2020 to identify English-language original research published in peer reviewed journals. This search yielded 9253 papers. A comprehensive search followed by 67 full text publication screenings by two independent reviewers yielded 15 papers meeting inclusion criteria. The study included three randomized control trials, one open label safety study, two case series, and six qualitative papers examining patient perspectives toward the LAIB prior to use. The team assessed the quality of studies via standardized quality assessment tools.
The LAIB was positively associated with improvements in abstinence, accessibility, employment, social relationships, and forensic matters. Limited evidence exists on gender equity within the current literature. The qualitative papers highlighted the importance of patients' preferences and individualization of treatment planning to ensure the success of MAT.
The quality of evidence was rated as medium or high risk of bias, which does limit interpretation of the results. Overall, the LAIB was positively associated with SDH and should be offered as part of MAT in alignment with the recovery model. Future research should evaluate the implementation and longitudinal impacts of LAI buprenorphine compared to treatment as usual (TAU).
本系统评价综合了关于使用新型长效注射用丁丙诺啡（LAIB）作为药物辅助治疗（MAT）的一部分的效果和观点的证据，及其对健康社会决定因素（SDH）的影响，特别是通过框架方法对禁欲、可及性、就业、法医事项以及性别和社会关系的影响。
研究团队在2010年1月至2020年6月期间检索了三个数据库，以识别发表在同行评审期刊上的英文原创研究。此次检索产生了9253篇论文。经过全面检索，由两名独立评审员进行67次全文发表筛选，产生了15篇符合纳入标准的论文。该研究包括三项随机对照试验、一项开放标签安全性研究、两项病例系列以及六篇定性论文，这些论文研究了患者在使用LAIB之前的观点。研究团队通过标准化质量评估工具评估研究质量。
LAIB与禁欲、可及性、就业、社会关系和法医事项的改善呈正相关。当前文献中关于性别平等的证据有限。定性论文强调了患者偏好和治疗计划个性化对于确保MAT成功的重要性。
证据质量被评为中等或高偏倚风险，这确实限制了对结果的解释。总体而言，LAIB与SDH呈正相关，应作为MAT的一部分根据康复模式提供。未来的研究应评估长效注射用丁丙诺啡与常规治疗（TAU）相比的实施情况和纵向影响。
