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丁丙诺啡综合治疗模式用于阿片类物质使用障碍的10年留存率

10-year retention of a comprehensive treatment model of buprenorphine for opioid use disorder.

作者信息

Zheng Wanhong, Cavrak Megan, Bowles Hannah, Deng Yongjia, Wen Sijin, Gao Si, Lander Laura, Berry James, Winstanley Erin L

机构信息

Department of Behavioral Medicine and Psychiatry, School of Medicine, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.

School of Medicine, West Virginia University, Morgantown, WV, USA.

出版信息

J Addict Dis. 2025 Jan-Mar;43(1):44-51. doi: 10.1080/10550887.2024.2315366. Epub 2024 Feb 24.

Abstract

BACKGROUND

There has been extensive research demonstrating the effectiveness of medications for opioid use disorder (MOUD) but limited investigation into its long-term retention rate.

OBJECTIVE

Assess the long-term treatment retention of a buprenorphine-based MOUD clinic with additional stratifications by age and gender.

METHODS

This retrospective study analyzed 10-years of data from a MOUD clinic in West Virginia that served 3,255 unique patients during the study period (2009-2019). Retention was measured by summation of total treatment days with a new episode of care defined as re-initiating buprenorphine treatment after 60+ consecutive days of nonattendance. Kaplan-Meier survival analysis, with the log-rank test, was used to compare retention by gender and age.

RESULTS

The mean age was 38 (SD = 10.6) and 95% were non-Hispanic white. Irrespective of treatment episode, 56.8% of patients were retained ≥ 90 days, and the overall median time in treatment was 112 days. Considering only the first treatment episode, 48.4% of 3,255 patients were retained at least 90 days and the overall median was 77 days. Female patients had  ≥ 90 day retention rate of 52.2% for the first admission and 60.1% for multiple admissions, both significantly higher than those of male subjects (44.1% and 53.0%). Additionally, patients ≤ 24 years old had the lowest rate of treatment retention, while patients aged ≥ 35 had the highest.

CONCLUSIONS

This study adds to the limited data regarding long-term retention in MOUD. Our findings indicate gender and age were highly correlated with retention in MOUD treatment.

摘要

背景

已有大量研究证明用于阿片类物质使用障碍的药物治疗(MOUD)的有效性,但对其长期留存率的研究有限。

目的

评估以丁丙诺啡为基础的MOUD诊所的长期治疗留存情况,并按年龄和性别进行额外分层分析。

方法

这项回顾性研究分析了西弗吉尼亚州一家MOUD诊所10年的数据,该诊所在研究期间(2009 - 2019年)为3255名不同患者提供服务。留存情况通过计算总治疗天数来衡量,新的治疗阶段定义为连续60天以上未就诊后重新开始丁丙诺啡治疗。采用Kaplan - Meier生存分析和对数秩检验来比较性别和年龄的留存情况。

结果

平均年龄为38岁(标准差 = 10.6),95%为非西班牙裔白人。无论治疗阶段如何,56.8%的患者留存时间≥90天,总体治疗中位时间为112天。仅考虑首次治疗阶段,3255名患者中有48.4%至少留存90天,总体中位数为77天。女性患者首次入院时≥90天的留存率为52.2%,多次入院时为60.1%,均显著高于男性患者(44.1%和53.0%)。此外,≤24岁的患者治疗留存率最低,而≥35岁的患者留存率最高。

结论

本研究增加了关于MOUD长期留存的有限数据。我们的研究结果表明,性别和年龄与MOUD治疗的留存高度相关。

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