Friends Research Institute Inc, United States of America.
Friends Research Institute Inc, United States of America.
J Subst Use Addict Treat. 2024 Jul;162:209334. doi: 10.1016/j.josat.2024.209334. Epub 2024 Mar 24.
The opioid epidemic in the United States has not spared youth or young adults, as evidenced by a six-fold increase in opioid use disorder (OUD) diagnoses in the last two decades. Given this dramatic rise, a call for greater uptake and accessibility of medications for opioid use disorder (MOUDs) among youth and young adults has ensued, resulting in an increasing number of MOUD treatment pathways for this vulnerable population.
This secondary data analysis seeks to characterize patient and provider preferences for MOUD treatment pathways, and test for associations between baseline MOUD treatment preferences and opioid use and treatment adherence outcomes. Participants included 288 youth and young adults (age 15-21 years), recruited from a residential treatment program in Maryland. The study assessed patient preferences at baseline (n = 253) and provider preferences at patient treatment discharge (n = 224). Mixed-effects negative binomial regression models were conducted for opioid use outcomes, and logistic regressions were conducted for treatment adherence outcomes.
Results indicate that congruence of treatment with patients' (Incidence Rate Ratio [IRR] = 0.65) and providers' (IRR = 0.66) preferences was significantly associated with reduced self-reported days of opioid use in the past 90 days, but only for patients receiving extended-release naltrexone (XR-NTX). Results also indicated that patients were less likely to switch medication treatment pathways (e.g., from XR-NTX to buprenorphine, or vice versa) during follow-up if they received their preferred treatment at baseline, a finding which held true for both XR-NTX (Odds Ratio [OR] = 0.32) and buprenorphine (OR = 0.22).
Receipt of MOUD congruent with patient and provider preferences was associated with reduced opioid use and greater treatment adherence in this sample of youth and young adults with OUD.
美国的阿片类药物泛滥并未放过年轻人或青年成年人，过去二十年中，阿片类药物使用障碍（OUD）的诊断增加了六倍，证明了这一点。鉴于这种急剧上升，人们呼吁在青年和青年成年人中更多地采用和获得治疗阿片类药物使用障碍（MOUD）的药物，从而为这一弱势群体提供了越来越多的 MOUD 治疗途径。
这项二次数据分析旨在描述患者和提供者对 MOUD 治疗途径的偏好，并测试 MOUD 治疗偏好与阿片类药物使用和治疗依从性结果之间的关联。参与者包括 288 名来自马里兰州一家住院治疗计划的青年和青年成年人（年龄 15-21 岁）。该研究在基线时评估了患者的偏好（n=253），并在患者治疗出院时评估了提供者的偏好（n=224）。使用混合效应负二项回归模型进行阿片类药物使用结果分析，使用逻辑回归进行治疗依从性结果分析。
结果表明，与患者（发病率比 [IRR] = 0.65）和提供者（IRR = 0.66）偏好一致的治疗与过去 90 天内自我报告的阿片类药物使用天数减少显著相关，但仅适用于接受延长释放纳曲酮（XR-NTX）的患者。结果还表明，如果患者在基线时接受了他们所偏好的治疗，那么在随访期间他们更不可能切换药物治疗途径（例如，从 XR-NTX 转为丁丙诺啡，或反之亦然），这一发现对于 XR-NTX（比值比 [OR] = 0.32）和丁丙诺啡（OR = 0.22）均成立。
在本项患有 OUD 的青年和青年成年人样本中，接受与患者和提供者偏好一致的 MOUD 治疗与阿片类药物使用减少和治疗依从性提高有关。
