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来自挪威首批海洛因辅助治疗诊所的患者特征。

Patient Characteristics From Norway's First Heroin-Assisted Treatment Clinics.

作者信息

Melis Francesca, Clausen Thomas, Castel Charlotte, Dadras Omid, De Pirro Silvana, Myklebust Lars Henrik, Oldervoll Ann, Wüsthoff Linda Elise, Eide Desiree

机构信息

Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.

出版信息

Subst Use Addctn J. 2025 Jan;46(1):13-24. doi: 10.1177/29767342241271991. Epub 2024 Sep 23.

Abstract

BACKGROUND

Heroin-assisted treatment (HAT) is an evidence-based treatment option for opioid use disorder (OUD), available in a limited number of countries. Norway implemented a 5-year HAT project in 2022, aiming to assess its effectiveness and its potential integration into the country's OUD treatment system. This study describes and compares patients' baseline characteristics from the Oslo and Bergen HAT clinics, providing a comprehensive picture of the unique population and the real-world application of HAT.

METHODS

This cross-sectional study examines the baseline characteristics of consenting HAT patients within the first 2 years of operation ( = 86). Self-reported questionnaires gathered sociodemographics, previous treatment experiences, self-reported crime, and substance use, as well as motivations and expectations for treatment. Comparisons between the clinics were carried out using -tests, Mann-Whitney tests, Chi-square, and Fisher's exact test.

RESULTS

The majority of the patients were enrolled at the Oslo clinic (76%) and were male (80%). At admission, the average age was 45.9, with a significantly younger group in Bergen (42.5 vs 47.3,  < .05). While no patients reported being unhoused, 17% noted unstable housing within the preceding month. Unemployment was prevalent (91%) alongside previous treatment experiences (95%), with a median of 2 prior medication types. In the 3 months preceding HAT initiation, 78% of patients reported being victims of crime, and 44% committed at least one crime. Over their lifetime, 2 in 5 participants (41%) had experienced an unwanted overdose and 43% had shared syringes and equipment.

CONCLUSION

This study reveals a cohort experiencing societal marginalization, including unstable housing, unsatisfactory prior OUD treatment, high-risk behaviors, and frequent interactions with criminal activities, predominantly as victims. While the Oslo and Bergen clinics serve a similar patient profile, notable differences emerged in the reasons for discontinuing past OUD treatment and crime-related factors.

摘要

背景

海洛因辅助治疗(HAT)是一种针对阿片类物质使用障碍(OUD)的循证治疗方案,仅在少数国家可用。挪威于2022年实施了一项为期5年的HAT项目,旨在评估其有效性以及将其纳入该国OUD治疗系统的潜力。本研究描述并比较了奥斯陆和卑尔根HAT诊所患者的基线特征,全面呈现了这一独特人群以及HAT在现实世界中的应用情况。

方法

这项横断面研究考察了运营头两年内同意接受HAT治疗的患者(n = 86)的基线特征。通过自我报告问卷收集社会人口统计学信息、既往治疗经历、自我报告的犯罪情况、物质使用情况,以及治疗动机和期望。诊所之间的比较采用t检验、曼 - 惠特尼U检验、卡方检验和费舍尔精确检验。

结果

大多数患者在奥斯陆诊所登记(76%),且为男性(80%)。入院时,平均年龄为45.9岁,卑尔根的患者群体明显更年轻(42.5岁对47.3岁,P < 0.05)。虽然没有患者报告无家可归,但17%的患者指出在前一个月内住房不稳定。失业情况普遍(91%),同时既往有治疗经历的情况也很常见(95%),之前使用过的药物类型中位数为2种。在开始HAT治疗前的3个月内,78%的患者报告曾是犯罪受害者,44%的患者至少实施过一次犯罪。在其一生中,五分之二的参与者(41%)曾经历过意外过量用药,43%的人曾共用过注射器和设备。

结论

本研究揭示了一个经历社会边缘化的队列,包括住房不稳定、既往OUD治疗效果不佳、高风险行为以及频繁与犯罪活动产生关联,主要是作为受害者。虽然奥斯陆和卑尔根诊所服务的患者概况相似,但在既往停止OUD治疗的原因和与犯罪相关的因素方面出现了显著差异。

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