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监测大麻使用障碍患者的依从性和戒断情况:特征识别与长期治疗结果的关系。

Monitoring adherence and abstinence of cannabis use disorder patients: Profile identification and relationship with long-term treatment outcomes.

机构信息

Department of Clinical and Experimental Psychology, University of Huelva. Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain.

Department of Clinical and Experimental Psychology, University of Huelva. Avda. Fuerzas Armadas s/n. 21071, Huelva, Spain; Research Center on Natural Resources, Health and the Environment, University of Huelva, Ed. Experimental Sciences, 21071 Huelva, Spain.

出版信息

J Subst Use Addict Treat. 2023 May;148:209019. doi: 10.1016/j.josat.2023.209019. Epub 2023 Mar 16.

Abstract

BACKGROUND

Patients with cannabis use disorder (CUD) show heterogeneous sociodemographic and consumption patterns. Although previous studies, focused on identifying subgroups of CUD patients using input variables, have yielded useful results for planning individualized treatments, no published research has analyzed the profiles of CUD patients according to their therapeutic progress. This study therefore aims to identify subgroups of patients using adherence and abstinence indicators and to explore whether these profiles are associated with sociodemographic characteristics, consumption variables, and long-term therapeutic outcomes.

METHODS

This was a retrospective observational study with a multisite sample of 2055 CUD outpatients who were beginning treatment. The study monitored patient data at two-year follow-up. We conducted latent profiles analysis on the appointment attendance ratio and percentage of negative cannabis tests.

RESULTS

A three profile solution emerged: i) moderate abstinence/moderate adherence (n = 997); ii) high abstinence/moderate adherence (n = 613); and iii) high abstinence/high adherence (n = 445). The study found the most marked differences at the beginning of treatment for education level (chi (8) = 121.70, p < .001), source of referral (chi (12) = 203.55, p < .001), and frequency of cannabis use (chi (10) = 232.39, p < .001). Eighty percent of patients from the "high abstinence/high adherence" group were relapse-free at two year follow-up. This percentage decreased to 24.3 % in the "moderate abstinence/moderate adherence" group.

CONCLUSIONS

Research has shown adherence and abstinence indicators to be useful for identifying subgroups of patients with different prognoses regarding long-term success. Recognizing the sociodemographic and consumption variables associated with these profiles at the beginning of treatment could help to inform the design of more individualized interventions.

摘要

背景

患有大麻使用障碍(CUD)的患者表现出异质的社会人口学和消费模式。尽管之前的研究侧重于使用输入变量来识别 CUD 患者的亚组,但这些研究为规划个体化治疗提供了有用的结果,但没有发表的研究根据治疗进展分析 CUD 患者的特征。因此,本研究旨在使用依从性和禁欲指标来识别患者亚组,并探讨这些特征是否与社会人口学特征、消费变量和长期治疗结果相关。

方法

这是一项具有多地点样本的 2055 名开始治疗的大麻使用障碍门诊患者的回顾性观察研究。该研究在两年随访时监测患者数据。我们对预约出勤率和阴性大麻检测百分比进行潜在剖面分析。

结果

出现了三种特征解决方案:i)中度禁欲/中度依从(n=997);ii)高度禁欲/中度依从(n=613);iii)高度禁欲/高度依从(n=445)。研究发现,在治疗开始时,教育水平(卡方(8)=121.70,p<.001)、转诊来源(卡方(12)=203.55,p<.001)和大麻使用频率(卡方(10)=232.39,p<.001)差异最为显著。80%来自“高度禁欲/高度依从”组的患者在两年随访时无复发。这一比例在“中度禁欲/中度依从”组降至 24.3%。

结论

研究表明,依从性和禁欲指标可用于识别具有不同长期成功预后的患者亚组。在治疗开始时识别与这些特征相关的社会人口学和消费变量,可能有助于制定更个体化的干预措施。

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