Homewood Research Institute, Guelph, ON, Canada.
Homewood Health Centre, Guelph, ON, Canada.
Curr Psychiatry Rep. 2024 May;26(5):215-221. doi: 10.1007/s11920-024-01495-3. Epub 2024 Mar 15.
Precision medicine prioritizes characterization of individual patient parameters to optimize care and this review evaluates measurement-based care (MBC) as a strategy for doing so in the treatment of substance use disorders (SUD). Measurement-based care refers to the systematic use of validated assessments to inform diagnosis and treatment planning, with varying frequency of assessments. Despite the seemingly obvious grounds for the use of MBC in treating SUD, systematic implementation to date has been limited. Thus, the goal of this review is to evaluate efforts to date and to stimulate greater consideration of MBC models in addictions programs.
Data from two published randomized controlled trials and findings from pragmatic clinical research highlight the potential utility of MBC in the SUD treatment settings. Despite these findings, the existing literature indicates the high need for larger-scale clinical trials and quality improvement programs. Potential barriers to the implementation of MBC for SUD are outlined at the patient, provider, organization, and system levels, as well as the challenges associated with the use of MBC programs for clinical research. Critical thinking considerations and risk mitigation strategies are offered toward advancing MBC for SUD beyond the current nascent state. Collectively, the existing data confirm that MBC is a suitable and promising strategy for applying a precision medicine approach in SUD treatment, warranting further implementation efforts and scientific inquiry.
目的综述：精准医学优先对个体患者的参数进行特征描述，以优化治疗效果。本综述评估了基于测量的医疗（MBC）作为治疗物质使用障碍（SUD）的一种策略。MBC 是指系统地使用经过验证的评估方法来辅助诊断和治疗计划，评估的频率有所不同。尽管基于测量的医疗在治疗 SUD 方面具有明显的应用基础，但迄今为止系统实施的范围有限。因此，本综述的目的是评估迄今为止的努力，并激发在成瘾项目中更多地考虑 MBC 模型。
最近发现：两项已发表的随机对照试验的数据以及实用临床研究的结果强调了 MBC 在 SUD 治疗环境中的潜在效用。尽管有这些发现，但现有文献表明需要进行更大规模的临床试验和质量改进计划。在患者、提供者、组织和系统层面上，概述了实施 MBC 治疗 SUD 的潜在障碍，以及与使用 MBC 计划进行临床研究相关的挑战。提出了批判性思维考虑因素和风险缓解策略，以推动 MBC 在 SUD 领域的应用超越当前的萌芽阶段。总的来说，现有数据证实 MBC 是一种合适且有前途的策略，可用于治疗 SUD，值得进一步实施努力和科学探究。
