Treatment retention among patients randomized to buprenorphine/naloxone compared to methadone in a multi-site trial.
Treatment retention among patients randomized to buprenorphine/naloxone compared to methadone in a multi-site trial.
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在一项多站点试验中，与美沙酮相比，随机分配给丁丙诺啡/纳洛酮的患者的治疗保留率。
DOI：
10.1111/add.12333
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发表时间：
2014-01
期刊：
影响因子：
--
通讯作者：
Ling W
中科院分区：
文献类型：
--
作者：
Hser YI;Saxon AJ;Huang D;Hasson A;Thomas C;Hillhouse M;Jacobs P;Teruya C;McLaughlin P;Wiest K;Cohen A;Ling W
检查美沙酮（MET）与丁丙诺啡/纳洛酮（BUP）治疗阿片类药物依赖中与保留和持续非法阿片类药物使用相关的患者和药物特征。这项二次分析包括2006年至2009年期间参加9个阿片类药物治疗项目的1，267名阿片类药物依赖者，并随机接受开放标签BUP或MET治疗24周。分析包括基线时患者特征的测量（人口统计学;酒精、香烟和非法药物的使用;自我评定的精神和身体健康），治疗期间的药物剂量和尿液药物筛查，以及24周试验期间的治疗完成和治疗天数。MET组的治疗完成率为74%，BUP组为46%（p<0.01）;当最大MET剂量达到或超过60 mg/天时，MET参与者的治疗完成率增加至80%。使用BUP，完成率随剂量增加而线性增加，剂量为30- 32 mg/天时达到60%。在那些仍在治疗的患者中，在治疗的前9周内，BUP患者的阿片类药物尿液阳性结果显著低于MET患者（OR=0.63，95%CI=0.52-0.76，p<0.01）。较高的药物剂量与较低的阿片类药物使用有关，尤其是在BUP患者中。考克斯比例风险模型揭示了与脱落相关的因素：（1）BUP（与MET相比，HR=1.61，CI：1.20-2.15），（2）较低的药物剂量（BUP <16 mg，MET <60 mg; HR=3.09，CI：2.19-4.37），（3）剂量和治疗条件的相互作用（BUP剂量较高的患者脱落的可能性是MET剂量较低的患者的1.04倍，以及（4）年龄较小，西班牙裔，治疗期间使用海洛因或其他物质。提供美沙酮似乎与阿片类药物依赖治疗中比丁丙诺啡更好的保留相关，使用更高剂量的两种药物也是如此。提供丁丙诺啡与持续使用非法阿片类药物的减少有关。
To examine patient and medication characteristics associated with retention and continued illicit opioid use in methadone (MET) versus buprenorphine/naloxone (BUP) treatment for opioid dependence. This secondary analysis included 1,267 opioid-dependent individuals participating in 9 opioid treatment programs between 2006 and 2009 and randomized to receive open-label BUP or MET for 24 weeks. The analyses included measures of patient characteristics at baseline (demographics; use of alcohol, cigarettes, and illicit drugs; self-rated mental and physical health), medication dose and urine drug screens during treatment, and treatment completion and days in treatment during the 24 week trial. The treatment completion rate was 74% for MET vs. 46% for BUP (p<.01); the rate among MET participants increased to 80% when the maximum MET dose reached or exceeded 60mg/day. With BUP, the completion rate increased linearly with higher doses, reaching 60% with doses of 30–32mg/day. Of those remaining in treatment, positive opioid urine results were significantly lower (OR=0.63, 95%CI=0.52–0.76, p<.01) among BUP relative to MET participants during the first 9 weeks of treatment. Higher medication dose was related to lower opiate use, more so among BUP patients. A Cox proportional hazards model revealed factors associated with dropout: (1) BUP (vs. MET, HR=1.61, CI:1.20–2.15), (2) lower medication dose (<16mg for BUP, <60mg for MET; HR=3.09, CI:2.19–4.37), (3) the interaction of dose and treatment condition (those with higher BUP dose were 1.04 times more likely to drop out than those with lower MET dose, and (4) being younger, Hispanic, and using heroin or other substances during treatment. Provision of methadone appears to be associated with better retention in treatment for opioid dependence than buprenorphine, as does use of provision of higher doses of both medications. Provision of buprenorphine is associated with lower continued use of illicit opioids.
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影响因子：
158.5
作者：
Fiellin, David A.;Pantalon, Michael V.;Schottenfeld, Richard S.
通讯作者：
Schottenfeld, Richard S.
影响因子：
6.7
作者：
Strain, E. C.;Harrison, J. A.;Bigelow, G. E.
通讯作者：
Bigelow, G. E.
影响因子：
120.7
作者：
Strain, EC;Bigelow, GE;Stitzer, ML
通讯作者：
Stitzer, ML
影响因子：
10.5
作者：
Haasen, Christian;Verthein, Uwe;Naber, Dieter
通讯作者：
Naber, Dieter
影响因子：
3.9
作者：
Pinto, Hayley;Maskrey, Vivienne;Holland, Richard
通讯作者：
Holland, Richard