Buprenorphine/naloxone treatment practices in Malaysia: Results of national surveys of physicians and patients
Buprenorphine/naloxone treatment practices in Malaysia: Results of national surveys of physicians and patients
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DOI：
10.1016/j.drugalcdep.2015.04.007
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发表时间：
2015-07-01
影响因子：
4.2
通讯作者：
Chawarski, M. C.
中科院分区：
文献类型：
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作者：
Vicknasingam, B.;Dazali, M. N. M.;Chawarski, M. C.
目的：丁丙诺啡/纳洛酮(Bup/NX)的药物辅助治疗，包括马来西亚全科医生的处方和配药实践，以及他们的患者使用这种治疗的经验，尚未得到系统的研究。目前的研究调查了马来西亚提供Bup/NX治疗的全科医生和接受办公室Bup/NX治疗的患者。方法：对在马来西亚半岛提供门诊Bup/NX维持治疗的全科医生(N=115)和正在接受Bup/NX治疗的患者(N=253)进行了两次横断面调查。结果：在过去的一个月里，医生给70%的患者开了2-4 mg的Bup/NX剂量，并对大约16%的患者进行了尿检。在患者调查中，79%的人报告每天服用2毫克或更少的Bup/NX；82%的人报告在过去一个月没有对他们进行尿毒学测试，36%的人在调查时尿液阿片类药物检测呈阳性，43%的人报告使用非法阿片类药物，15%的人报告注射海洛因，22%的人报告在过去一个月注射Bup/NX。结论：Bup/NX的日剂量较低，缺乏行为监测或咨询，以及持续吸毒率高，包括在马来西亚Bup/NX治疗期间注射药物和药物，表明持续存在实施问题和治疗效果不佳。在马来西亚，Bup/NX的高成本可能会阻止患者寻求治疗，并有助于服用低剂量的Bup/NX。为了改善护理和治疗反应，可能需要改进对医生的培训，并建立Bup/NX剂量、常规毒理学测试和咨询的标准。(C)2015爱思唯尔爱尔兰有限公司。保留所有权利。
Objective: Medication assisted treatment with buprenorphine/naloxone (Bup/Nx), including prescribing and dispensing practices of general practitioners (GPs) in Malaysia and their patients' experiences with this treatment have not been systematically examined. The current study surveyed GPs providing Bup/Nx treatment and patients receiving office-based Bup/Nx treatment in Malaysia.Methods: Two cross-sectional surveys of GPs (N = 115) providing outpatient Bup/Nx maintenance treatment and of patients (N = 253) currently receiving Bup/Nx treatment throughout peninsular Malaysia.Results: Physicians prescribed Bup/Nx dosages in the range of 2-4 mg daily for 70% of patients and conducted urine testing in the past month on approximately 16% of their patients. In the patient survey, 79% reported taking daily Bup/Nx doses of 2 mg or less; 82% reported that no urine toxicology testing had been conducted on them in the past month, 36% had an opiate positive urine test at the time of the survey, 43% reported illicit opiate use, 15% reported injection of heroin and 22% reported injection of Bup/Nx in the past month.Conclusion: Low daily Bup/Nx doses, lack of behavioral monitoring or counseling, and high rates of continued drug use, including injection of drugs and medications during Bup/Nx treatment in Malaysia, indicate continuing problems with implementation and less than optimal treatment effectiveness. High cost of Bup/Nx in Malaysia may deter patients from seeking treatment and contribute to taking low Bup/Nx dosages. Improved training of physicians and establishing standards for Bup/Nx dosing, routine toxicology testing, and counseling may be needed to improve care and treatment response. (C) 2015 Elsevier Ireland Ltd. All rights reserved.