Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA.
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
J Subst Use Addict Treat. 2024 Aug;163:209383. doi: 10.1016/j.josat.2024.209383. Epub 2024 Apr 24.
Over the past decade, treatment for opioid use disorder has expanded to include long-acting injectable and implantable formulations of medication for opioid use disorder (MOUD), and integrated treatment models systematically addressing both behavioral and physical health. Patient preference for these treatment options has been underexplored. Gathering data on OUD treatment preferences is critical to guide the development of patient-centered treatment for OUD. This cross-sectional study assessed preferences for long-acting MOUD and integrated treatment using an online survey.
An online Qualtrics survey assessed preferences for MOUD formulation and integrated treatment models. The study recruited participants (n = 851) in October and November 2019 through advertisements or posts on Facebook, Google AdWords, Reddit, and Amazon Mechanical Turk (mTurk). Eligible participants scored a two or higher on the opioid pain reliever or heroin scales of the Tobacco, Alcohol Prescription Medication and other Substance Use (TAPS) Tool. Structured survey items obtained patient preference for MOUD formulation and treatment model. Using stated preference methods, the study assessed preference via comparison of preferred options for MOUD and treatment model.
In the past year, 824 (96.8 %) participants reported non-prescribed use of opioid pain relievers (mean TAPS score = 2.72, SD = 0.46) and 552 (64.9 %) reported heroin or fentanyl use (mean TAPS score = 2.73, SD = 0.51). Seventy-four percent of participants (n = 631) reported currently or previously receiving OUD treatment, with 407 (48.4 %) receiving MOUD. When asked about preferences for type of MOUD formulation, 452 (53.1 %) preferred a daily oral formulation, 115 (13.5 %) preferred an implant, 114 (13.4 %) preferred a monthly injection and 95 (11.2 %) preferred a weekly injection. Approximately 8.8 % (n = 75) would not consider MOUD regardless of formulation. The majority of participants (65.2 %, n = 555) preferred receiving treatment in a specialized substance use treatment program distinct from their medical care, compared with receiving care in an integrated model (n = 296, 34.8 %).
Though most participants expressed willingness to try long-acting MOUD formulations, the majority preferred short-acting formulations. Likewise, the majority preferred non-integrated treatment in specialty substance use settings. Reasons for these preferences provide insight on developing effective educational tools for patients and suggesting targets for intervention to develop a more acceptable treatment system.
在过去的十年中，阿片类药物使用障碍的治疗方法已经扩展到包括长效注射和植入式阿片类药物使用障碍（MOUD）药物，以及系统地解决行为和身体健康问题的综合治疗模式。患者对这些治疗方案的偏好尚未得到充分探索。收集阿片类药物使用障碍治疗偏好的数据对于指导以患者为中心的阿片类药物使用障碍治疗的发展至关重要。这项横断面研究使用在线调查评估了对长效 MOUD 和综合治疗的偏好。
一项在线的 Qualtrics 调查评估了对 MOUD 配方和综合治疗模式的偏好。该研究于 2019 年 10 月至 11 月通过 Facebook、Google AdWords、Reddit 和亚马逊 Mechanical Turk（mTurk）上的广告或帖子招募参与者（n=851）。合格参与者在烟草、酒精处方药物和其他物质使用（TAPS）工具的阿片类止痛药或海洛因量表上得分为 2 或更高。结构化调查项目获得了患者对 MOUD 配方和治疗模式的偏好。通过使用陈述偏好方法，该研究通过比较 MOUD 和治疗模型的首选选项来评估偏好。
在过去的一年中，824 名（96.8%）参与者报告非处方使用阿片类止痛药（平均 TAPS 得分为 2.72，标准差为 0.46），552 名（64.9%）报告使用海洛因或芬太尼（平均 TAPS 得分为 2.73，标准差为 0.51）。74%的参与者（n=631）报告目前或以前接受过阿片类药物使用障碍治疗，其中 407 名（48.4%）接受过 MOUD 治疗。当被问及对 MOUD 制剂类型的偏好时，452 名（53.1%）参与者更喜欢每日口服制剂，115 名（13.5%）更喜欢植入物，114 名（13.4%）更喜欢每月注射，95 名（11.2%）更喜欢每周注射。约 8.8%（n=75）无论制剂如何，都不会考虑 MOUD。与接受综合治疗模式相比，大多数参与者（65.2%，n=555）更愿意在专门的物质使用治疗项目中接受治疗，而不是在综合模式下接受治疗（n=296，34.8%）。
尽管大多数参与者表示愿意尝试长效 MOUD 制剂，但大多数人更喜欢短效制剂。同样，大多数人更喜欢在专门的物质使用环境中接受非综合治疗。这些偏好的原因提供了对患者开发有效教育工具的见解，并为干预措施的目标提出了建议，以开发更能被接受的治疗系统。
