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探索患者对长效丁丙诺啡制剂的体验与满意度:一项混合方法研究。

Exploring patient experience and satisfaction with depot buprenorphine formulations: A mixed-methods study.

作者信息

Allen Eve, Samadian Sona, Altobelli Gary, Johnson Jacinta, Holmwood Chris

机构信息

UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia.

Drug and Alcohol Services South Australia, SA Health, Adelaide, Australia.

出版信息

Drug Alcohol Rev. 2023 May;42(4):791-802. doi: 10.1111/dar.13616. Epub 2023 Feb 14.

Abstract

INTRODUCTION

The introduction of depot buprenorphine for the treatment of opioid dependence allows for reduced dosing frequency compared with conventional treatments, such as oral methadone and sublingual buprenorphine-naloxone. Reduced dosing frequency is perceived to reduce issues such as high out-of-pocket costs, frequent attendance to pharmacies, stigmatisation and the risk of diversion for unsanctioned opioid use. This study aims to explore the experiences of patients receiving depot buprenorphine from an Australian publicly operated drug and alcohol service.

METHODS

Participants were recruited from the service over a 5-week period in 2021. Twenty-eight participants consented to be involved in a mixed methods quantitative verbal survey and qualitative interview process.

RESULTS

The majority of participants reported satisfaction with depot buprenorphine across the domains of efficacy, convenience and global satisfaction. Participants perceived benefits as increased convenience, reduced stigmatisation and the inability to 'skip' daily Medication Assisted Treatment for Opioid Dependence (MATOD) doses. There were mixed experiences with the ability for depot buprenorphine to 'hold' participants throughout the dosing interval. Reduced contact and disconnection from healthcare services were reported as an issue for some participants when initiating depot buprenorphine.

DISCUSSION AND CONCLUSIONS

Patient perceptions of depot buprenorphine appear to be deeply rooted in prior experience with 'conventional' MATOD treatments. Depot buprenorphine is seen to be beneficial socially, personally, and financially by the majority of patients interviewed. The potential for disconnection from services and mixed experiences of efficacy throughout the dosing period may negatively influence patient experience.

摘要

引言

与传统治疗方法(如口服美沙酮和舌下含服丁丙诺啡 - 纳洛酮)相比,引入长效丁丙诺啡用于治疗阿片类药物依赖可降低给药频率。给药频率降低被认为可以减少诸如高额自付费用、频繁前往药房、污名化以及未经许可使用阿片类药物导致药物转移的风险等问题。本研究旨在探讨在澳大利亚一家由政府运营的药物和酒精服务机构接受长效丁丙诺啡治疗的患者的体验。

方法

2021年,在为期5周的时间里从该服务机构招募参与者。28名参与者同意参与一项混合方法的定量口头调查和定性访谈过程。

结果

大多数参与者在疗效、便利性和总体满意度等方面对长效丁丙诺啡表示满意。参与者认为其好处包括便利性增加、污名化减少以及无法“跳过”每日的阿片类药物依赖药物辅助治疗(MATOD)剂量。对于长效丁丙诺啡在整个给药间隔期“维持”参与者治疗的能力,体验不一。一些参与者报告称,在开始使用长效丁丙诺啡时,与医疗服务的接触减少和脱节是一个问题。

讨论与结论

患者对长效丁丙诺啡的看法似乎深深植根于之前使用“传统”MATOD治疗的经历。大多数接受访谈的患者认为长效丁丙诺啡在社会、个人和经济方面都有益处。在整个给药期间与服务脱节的可能性以及疗效体验不一可能会对患者体验产生负面影响。

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