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接受丁丙诺啡/纳洛酮治疗阿片类药物使用障碍的患者的治疗体验:一项对患者感知和态度的定性研究。

Treatment Experiences for Patients Receiving Buprenorphine/Naloxone for Opioid Use Disorder: A Qualitative Study of Patients' Perceptions and Attitudes.

机构信息

Center for Health Policy and Healthcare Research, Northeastern University, Boston, Massachusetts, USA.

Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts, USA.

出版信息

Subst Use Misuse. 2023;58(4):512-519. doi: 10.1080/10826084.2023.2177111. Epub 2023 Feb 10.

Abstract

Although buprenorphine/naloxone has been demonstrated to be an effective treatment for patients with opioid use disorder (OUD), treatment retention has been a challenge. This study extends what is presently a limited literature regarding patients' experiences with this medication and the implications for treatment retention. The study was conducted as a qualitative investigation of patients in treatment for OUD at the time of the study. Forty-three patients (27 men, 15 women, mean age 34.7) were recruited from three clinical settings, a community health center, an academically-based treatment site, and an independent substance abuse treatment facility. Most patients had returned to use in the past after attempts to become abstinent. Patients generally reported positive experiences with this medication noting it helped to reduce opioid cravings quickly. As important considerations for treatment retention, patients emphasized a firm commitment to achieving abstinence when beginning treatment and a prescriber who is informed about and attentive to their emotional state. Diverging attitudes did exist regarding treatment duration as some patients were accepting of long-term treatment while others desired a relatively brief option. Among patients who had returned to use, potentially important issues emerged pertaining to the absence of patient outreach for missed medication appointments and inadequate discharge planning following stays at rehabilitation facilities. While results regarding the importance of patient motivation and strong patient-prescriber relationships have been noted in previous studies, other findings regarding opportunities to improve patient outreach and coordination of care have received relatively less attention and warrant further consideration.

摘要

虽然丁丙诺啡/纳洛酮已被证明是治疗阿片类药物使用障碍(OUD)患者的有效方法,但治疗保留一直是一个挑战。这项研究扩展了目前关于患者使用这种药物的经验及其对治疗保留的影响的有限文献。该研究是对当时正在接受 OUD 治疗的患者进行的定性调查。从三个临床环境中招募了 43 名患者(27 名男性,15 名女性,平均年龄 34.7 岁),包括社区卫生中心、基于学术的治疗场所和独立的药物滥用治疗设施。大多数患者在试图戒断后过去都有过复吸的经历。患者普遍报告对这种药物有积极的体验,称其有助于快速减少阿片类药物的渴望。作为治疗保留的重要考虑因素,患者强调在开始治疗时坚定地实现戒断的承诺,以及对他们的情绪状态有了解并关注的处方医生。关于治疗持续时间,患者的态度存在分歧,一些患者接受长期治疗,而另一些患者则希望选择相对较短的治疗方案。在已经复吸的患者中,出现了一些潜在重要的问题,涉及到对错过药物预约的患者缺乏联系以及康复设施出院后的计划不足。虽然之前的研究已经注意到患者动机和强大的医患关系的重要性,但其他关于改善患者外联和护理协调的机会的发现相对较少受到关注,值得进一步考虑。

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