West Virginia Alliance for Creative Health Solutions, Inc, Culloden, WV, USA.
J Prim Care Community Health. 2023 Jan-Dec;14:21501319231195606. doi: 10.1177/21501319231195606.
Medication assisted treatment (MAT) for opioid use disorder (OUD) saves lives and enhances quality of life for people in recovery. However, only a small percentage of people eligible for MAT in the United States receive treatment, and among those who do seek treatment, retention is a challenge. This study aims to understand factors that help individuals enter and stay in MAT from the perspective of those in recovery. The patient perspective is vital in efforts to improve care delivery and best support individuals in treatment.
Survey development was driven by a review of current peer-reviewed literature plus information gained through 3 semi-structured interviews and follow-up discussions with 5 individuals who have lived experience in MAT, termed Participant Advisors. Survey questions focused in part on MAT participants' opinions relating to program policies such as drug testing, relapse protocols, duration of treatment, participant use of anti-anxiety medications and marijuana, and requirements for attendance in peer recovery groups such as Narcotics Anonymous and Alcoholics Anonymous. Responses were collected from West Virginia-based MAT programs from February through August 2021, with 1700 surveys distributed to 21 MAT programs.
At the close of data collection, 225 survey responses, including over 500 free-text comments, were received (13.2% response rate). Most (n = 207, 95%) were currently in a MAT program and most (n = 187, 88.6%) reported using buprenorphine/naloxone for MAT, though participants reported having used other medications for treatment of OUD as well. Questions about how long a person should have MAT prescribed, how long they should be able to stay in treatment, whether they can use marijuana or anti-anxiety drugs while in treatment, and whether they should use a 12-step program generated mixed opinions. Findings strongly support consideration of individual situations and shared decision-making with providers.
阿片类药物使用障碍（OUD）的药物辅助治疗（MAT）挽救了生命，并提高了康复人群的生活质量。然而，在美国有资格接受 MAT 治疗的人中，只有一小部分人接受了治疗，而在寻求治疗的人中，保留率是一个挑战。这项研究旨在从康复者的角度了解帮助个人进入和留在 MAT 的因素。患者的观点对于改善护理服务的提供和最好地支持治疗中的个人至关重要。
调查的制定是基于对当前同行评议文献的回顾，以及通过与 5 名有 MAT 生活经验的人（称为参与者顾问）进行 3 次半结构化访谈和后续讨论获得的信息。调查问题主要集中在 MAT 参与者对项目政策的看法上，例如药物测试、复发协议、治疗时间、参与者使用抗焦虑药物和大麻以及参加同伴康复团体（如匿名吸毒者和匿名酗酒者）的要求。调查于 2021 年 2 月至 8 月在西弗吉尼亚州的 MAT 项目中进行，向 21 个 MAT 项目发放了 1700 份调查问卷。
在数据收集结束时，共收到 225 份调查问卷的回复，其中包括 500 多条自由文本评论（13.2%的回复率）。大多数（n=207，95%）目前正在接受 MAT 治疗，大多数（n=187，88.6%）报告使用丁丙诺啡/纳洛酮进行 MAT，但参与者也报告使用过其他药物治疗 OUD。关于一个人应该接受 MAT 治疗多久、他们应该能够在治疗中停留多久、他们在治疗期间是否可以使用大麻或抗焦虑药物以及他们是否应该使用 12 步程序的问题，引发了不同意见。研究结果强烈支持考虑个人情况和与提供者共同决策。
