Buprenorphine retention in primary care.
Buprenorphine retention in primary care.
复制标题
初级保健中的丁丙诺啡保留。
DOI：
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发表时间：
2005
影响因子：
5.7
通讯作者：
P. Friedmann
中科院分区：
文献类型：
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作者：
M. Stein;P. Cioe;P. Friedmann
背景
本研究评估了阿片类药物依赖性初级保健患者服用丁丙诺啡（一种长效部分阿片类激动剂）的治疗保留率和预测因素。
方法
罗德岛州初级保健诊所采用丁丙诺啡/纳洛酮后，对服用丁丙诺啡/纳洛酮的患者进行了为期 6 个月的观察性队列研究。实践政策不允许患者因继续吸毒而出院。
结果
患者 (n=41) 平均使用阿片类药物持续时间为 15.7 年，大多数有海洛因使用史 (63.4%)。百分之三十九的患者从美沙酮维持治疗中转过来。 24 周时，59% 仍在接受治疗。近一半的辍学发生在前 30 天。在第 1 周出现阿片类药物阳性毒理学的参与者更有可能退出该计划 (P<.01)，并且平均保留时间显着较短 (P<.01)。在其他药物使用和药物治疗变量中，治疗期间的就业和成瘾咨询与治疗保留显着相关（P=.03）。
结论
在现实世界中，基于初级保健的丁丙诺啡维持实践中的保留率反映了临床试验中报告的结果。治疗第一周的禁欲和接受咨询对于保留患者至关重要。
BACKGROUND
This study assesses the rate and predictors of treatment retention for primary care patients with opioid dependence-prescribed buprenorphine, a long-acting partial opioid agonist.
METHODS
Observational cohort study of patients prescribed buprenorphine/naloxone and followed for 6 months in the period after the adoption of buprenophine/naloxone by a primary care practice in Rhode Island. Practice policy precluded patient discharges due to continuing drug use.
RESULTS
Patients (n=41) had a mean duration of opioid use of 15.7 years and most had a history of heroin use (63.4%). Thirty-nine percent of patients transferred from methadone maintenance. At 24 weeks, 59% remained in treatment. Nearly half of dropouts occurred in the first 30 days. Participants with opiate-positive toxicologies at week 1 were more likely to drop out of the program (P<.01) and had a significantly shorter retention time (P<.01) on average. Among other drug use and drug treatment variables, employment and addiction counseling during treatment were significantly associated with treatment retention (P=.03).
CONCLUSION
Retention rates in a real world, primary care-based buprenorphine maintenance practice reflect those reported in clinical trials. Abstinence during the first week of treatment and receipt of counseling were critical to patient retention.