Nehlin Christina, Bäckström Josefin, Brander Charlotte Wollert, Öster Caisa
Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden.
Division of Psychiatry, Uppsala University Hospital, Uppsala, Sweden.
Subst Abuse. 2022 Jun 21;16:11782218221107021. doi: 10.1177/11782218221107021. eCollection 2022.
Opioid agonist treatment (OAT) programs are life-saving, as they reduce opioid use, overdoses, and criminal activities. Disadvantages reported with long-term OAT include side effects of the medication, especially on cognitive ability and sexual function, which may discourage potential participants. Many of those who participate in OAT have a desire to come off treatment. The aims of this study were to explore patients' thoughts about coming off OAT and to investigate their perceptions of what support they would need in order to realize a planned withdrawal from OAT.
A qualitative interview study with semi-structured interviews, using applied thematic analysis. Persons with experiences of participating in OAT were invited from Swedish programs and a private Facebook community.
Fifteen persons, with a mean of 9.6 (±6.4) years of treatment experience, were included. The participants underlined the need for a patient-centered focus within the treatment. They wanted to be regarded as capable of deciding if, when, and how a planned ending was to take place. They also called for staff to be supportive in making such decisions. Participants recommended staff to be sensitive to the needs of the specific patient and to have strategies for coming off OAT that could be adjusted for the single person.
OAT programs need to be continually updated and adapted to the persons who can benefit from them. Applying a person-centered, holistic perspective would enhance the quality of the treatment by emanating from individual goals. Regulatory guidelines need to take into account research on patient experiences and perspectives on coming off.
阿片类激动剂治疗（OAT）项目可挽救生命，因为它们能减少阿片类药物使用、过量用药及犯罪活动。长期OAT的缺点包括药物副作用，尤其是对认知能力和性功能的影响，这可能会使潜在参与者望而却步。许多参与OAT的人都希望停止治疗。本研究的目的是探讨患者对停止OAT的想法，并调查他们对于为实现有计划地从OAT中退出所需支持的看法。
采用应用主题分析法进行半结构化访谈的定性研究。从瑞典的项目和一个私人脸书社区中邀请有OAT参与经历的人。
纳入了15人，平均治疗经验为9.6（±6.4）年。参与者强调治疗中需要以患者为中心。他们希望被视为有能力决定是否、何时以及如何进行有计划的结束。他们还呼吁工作人员在做出此类决定时给予支持。参与者建议工作人员对特定患者的需求保持敏感，并拥有可针对个体进行调整的OAT停药策略。
OAT项目需要不断更新并适应能从中受益的人群。采用以患者为中心的整体视角，从个体目标出发，将提高治疗质量。监管指南需要考虑关于患者停药经历和观点的研究。
