Patient characteristics associated with buprenorphine/naloxone treatment outcome for prescription opioid dependence: Results from a multisite study
Patient characteristics associated with buprenorphine/naloxone treatment outcome for prescription opioid dependence: Results from a multisite study
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DOI：
10.1016/j.drugalcdep.2012.12.010
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发表时间：
2013-07-01
影响因子：
4.2
通讯作者：
Weiss, Roger D.
中科院分区：
文献类型：
--
作者：
Dreifuss, Jessica A.;Griffin, Margaret L.;Weiss, Roger D.
背景资料：处方阿片类药物依赖是一个日益严重的问题，但很少有研究存在于其治疗，包括患者的特点，预测治疗结果。对一项大型多中心随机临床试验数据的二次分析，国家药物滥用治疗临床试验网络处方阿片类药物成瘾治疗研究（POATS）是为了检查基线患者特征（N=360）与12周丁丙诺啡/纳洛酮治疗处方阿片类药物依赖期间的成功相关。基线预测变量包括自我报告的人口统计学和阿片类药物使用史信息，通过复合国际诊断访谈评估的诊断，以及阿片类药物使用史和来自疼痛和阿片类镇痛药使用史的相关信息。在双变量分析中，与成功使用阿片类药物结局相关的治疗前特征包括年龄较大，过去一年或终生诊断为重度抑郁症，最初通过医疗处方获得阿片类药物以缓解疼痛，仅通过吞咽或舌下给药使用阿片类药物，从未使用过海洛因，最常使用的阿片类药物不是缓释羟考酮，既往未接受过阿片类药物依赖治疗。在多变量分析中，年龄，终身重度抑郁症，只使用阿片类药物通过吞咽或舌下给药，并没有收到以前的阿片类药物依赖治疗仍然是成功的outcome.Conclusions的显着预测因素：这是第一个研究的特点与治疗结果的患者完全依赖于处方阿片类药物。与丁丙诺啡/纳洛酮治疗12周后成功结局相关的特征包括一些先前已发现可预测海洛因依赖患者对美沙酮治疗的反应的特征，以及一些特定于接受丁丙诺啡/纳洛酮的处方阿片类药物依赖患者的特征。(C)2012爱思唯尔爱尔兰有限公司保留所有权利。
Background: Prescription opioid dependence is a growing problem, but little research exists on its treatment, including patient characteristics that predict treatment outcome.Methods: A secondary analysis of data from a large multisite, randomized clinical trial, the National Drug Abuse Treatment Clinical Trials Network Prescription Opioid Addiction Treatment Study (POATS) was undertaken to examine baseline patient characteristics (N=360) associated with success during 12-week buprenorphine/naloxone treatment for prescription opioid dependence. Baseline predictor variables included self-reported demographic and opioid use history information, diagnoses assessed via the Composite International Diagnostic Interview, and historical opioid use and related information from the Pain And Opiate Analgesic Use History.Results: In bivariate analyses, pre-treatment characteristics associated with successful opioid use outcome included older age, past-year or lifetime diagnosis of major depressive disorder, initially obtaining opioids with a medical prescription to relieve pain, having only used opioids by swallowing or sublingual administration, never having used heroin, using an opioid other than extended-release oxycodone most frequently, and no prior opioid dependence treatment. In multivariate analysis, age, lifetime major depressive disorder, having only used opioids by swallowing or sublingual administration, and receiving no prior opioid dependence treatment remained as significant predictors of successful outcome.Conclusions: This is the first study to examine characteristics associated with treatment outcome in patients dependent exclusively on prescription opioids. Characteristics associated with successful outcome after 12 weeks of buprenorphine/naloxone treatment include some that have previously been found to predict heroin-dependent patients' response to methadone treatment and some specific to prescription opioid-dependent patients receiving buprenorphine/naloxone. (C) 2012 Elsevier Ireland Ltd. All rights reserved.