Hall S M, Tunis S, Triffleman E, Banys P, Clark H W, Tusel D, Stewart P, Presti D
Department of Veterans Affairs Medical Center, San Francisco, California.
J Nerv Ment Dis. 1994 Oct;182(10):570-5.
The objective of this research was to determine the efficacy of enhanced continuity of care and desipramine in increasing treatment attendance and abstinence from cocaine in primary cocaine abusers. Study design was a random assignment, placebo-controlled factorial with assessments at baseline and at 3 (first week of outpatient treatment), 8, and 12 weeks after start of study. Desipramine blood levels were taken at weeks 2 (inpatient), 3, and 8. Subjects (N = 94 men) were recruited on an inpatient ward and assigned to increased continuity of care or to standard treatment, and to active or placebo drug. Main outcome variables were toxicology-verified reports of cocaine use, and attendance at counseling sessions. Enhanced continuity of care increased abstinence from cocaine at week 3 and increased attendance at individual counseling sessions throughout the 12 weeks of the study. There were no main effects for desipramine. Blood levels above 123 ng/ml at week 2 predicted longer stays in outpatient. We conclude that enhanced continuity of care is a low cost intervention that improves early treatment outcome and attendance; desipramine effects do not warrant its therapeutic use.
本研究的目的是确定强化连续性护理和去郁敏在提高原发性可卡因滥用者的治疗出勤率和戒除可卡因方面的疗效。研究设计为随机分配、安慰剂对照析因设计，在基线以及研究开始后的3周（门诊治疗的第一周）、8周和12周进行评估。在第2周（住院期间）、第3周和第8周测定去郁敏的血药浓度。研究对象（N = 94名男性）在一个住院病房招募，被分配到强化连续性护理组或标准治疗组，并接受活性药物或安慰剂治疗。主要结局变量是经毒理学验证的可卡因使用报告以及咨询会议的出勤率。强化连续性护理在第3周提高了可卡因戒除率，并在整个12周的研究中提高了个体咨询会议的出勤率。去郁敏没有主要作用。第2周血药浓度高于123 ng/ml预示着门诊停留时间更长。我们得出结论，强化连续性护理是一种低成本干预措施，可改善早期治疗结局和出勤率；去郁敏的效果不支持其用于治疗。
