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纳入患者报告结局以指导阿片类物质使用障碍治疗效果评估:一项系统评价

The Inclusion of Patients' Reported Outcomes to Inform Treatment Effectiveness Measures in Opioid Use Disorder. A Systematic Review.

作者信息

Sanger Nitika, Panesar Balpreet, Dennis Michael, Rosic Tea, Rodrigues Myanca, Lovell Elizabeth, Yang Shuling, Butt Mehreen, Thabane Lehana, Samaan Zainab

机构信息

Medical Science Graduate Program, McMaster University, Hamilton, Ontario, Canada.

Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada.

出版信息

Patient Relat Outcome Meas. 2022 May 30;13:113-130. doi: 10.2147/PROM.S297699. eCollection 2022.

Abstract

INTRODUCTION

Patient centred care is needed now more than ever in the treatment of opioid use disorder. Trials, policy makers, and service providers have most often used treatment retention and opioid urine screens as measures of treatment effectiveness. However, patients receiving medication for opioid use disorder treatment (MOUD) may prioritise the use of different ways to assess treatment success.

OBJECTIVE

The aim of this review is to synthesize literature examining the self-reported goals patients would like to achieve in MOUD for opioid use disorder.

METHODS

We searched MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Cochrane Library, Cochrane Clinical Trials Registry, the National Institutes for Health Clinical Trials Registry, and the WHO International Clinical Trials Registry Platform from inception until April 30th, 2021. No restrictions were placed on language, age, or type of MOUD. A qualitative synthesis is presented given that a meta-analysis was not possible.

RESULTS

The search yielded a total of 21,082 records from which 8 met criteria for inclusion in the qualitative synthesis. We identified a total of 43 patient-reported treatment goals from the 8 studies. Twelve domains were created from the 43 goals reported. These domains cover a range of important areas for patients' goals related to living a normal life, physical health, mental health, treatment, and substance use specific areas.

CONCLUSION

This review highlights several patient goals that they would like to achieve during treatment for opioid use disorder that are not commonly considered as markers of treatment effectiveness. Goals related to health, living a normal life, and overall substance use concerns by patients should be taken into consideration by clinical trialists, researchers, policy makers, service providers, patients, and communities engaged in developing and tailoring treatment plans for opioid use disorder.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42018095553.

摘要

引言

在阿片类药物使用障碍的治疗中,以患者为中心的护理比以往任何时候都更加必要。试验、政策制定者和服务提供者最常将治疗保留率和阿片类药物尿液筛查作为治疗效果的衡量标准。然而,接受阿片类药物使用障碍治疗药物(MOUD)的患者可能会优先使用不同的方法来评估治疗成功与否。

目的

本综述的目的是综合研究文献,探讨患者自述在阿片类药物使用障碍的MOUD治疗中希望实现的目标。

方法

我们检索了MEDLINE、EMBASE、PsycINFO、护理及相关健康文献累积索引、科学网、考克兰图书馆、考克兰临床试验注册库、美国国立卫生研究院临床试验注册库以及世界卫生组织国际临床试验注册平台,检索时间从数据库建立至2021年4月30日。对MOUD的语言、年龄或类型均无限制。由于无法进行荟萃分析,因此进行了定性综合分析。

结果

检索共获得21,082条记录,其中8条符合纳入定性综合分析的标准。我们从这8项研究中总共确定了43个患者自述的治疗目标。根据报告的43个目标创建了12个领域。这些领域涵盖了一系列与患者正常生活、身体健康、心理健康、治疗以及物质使用特定领域相关的重要目标领域。

结论

本综述强调了患者在阿片类药物使用障碍治疗期间希望实现的几个目标,这些目标通常不被视为治疗效果的指标。参与制定和调整阿片类药物使用障碍治疗计划的临床试验人员、研究人员、政策制定者、服务提供者、患者和社区应考虑患者与健康、正常生活以及总体物质使用相关的目标。

系统评价注册

PROSPERO CRD42018095553。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d33/9165704/a9464efc03c0/PROM-13-113-g0001.jpg

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