Evidence of validity and reliability of the Opiate Dosage Adequacy Scale (ODAS) in a sample of heroin addicted patients in buprenorphine/naloxone maintenance treatment
Evidence of validity and reliability of the Opiate Dosage Adequacy Scale (ODAS) in a sample of heroin addicted patients in buprenorphine/naloxone maintenance treatment
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DOI：
10.1016/j.drugalcdep.2017.10.035
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发表时间：
2018-02-01
影响因子：
4.2
通讯作者：
Perez de los Cobos, Jose
中科院分区：
文献类型：
--
作者：
Gonzalez-Saiz, Francisco;Lozano Rojas, Oscar;Perez de los Cobos, Jose
目的：阿片类药物剂量充足量表（ODAS）是一种单独衡量维持治疗患者阿片类药物剂量“充足性”的临床工具。本文旨在为丁丙诺啡/纳洛酮（B/N）维持治疗患者样本中ODAS的效度和可靠性提供证据。方法：对来自西班牙四个自治区的B/ n治疗患者（n = 316）的方便样本进行横断面研究。参与者完成了一系列评估工具：丁丙诺啡剂量充足性；海洛因依赖严重程度；心理调节;以及患者期望的丁丙诺啡剂量调整。结果：探索性因子分析从ODAS中确定了四个因素，共占总方差的85.4%：“海洛因渴望和使用”；“Overmedication”;“客观阿片戒断症状”和“主观阿片戒断症状”。患者相比,“不足”B / N剂量(oda),“足够”患者剂量减少了海洛因使用上周(0.01 vs 0.40; t = -2.73; p < 0.01, 95%置信区间CI: -0.67, -0.10),那么严重海洛因依赖(t = 5.14, 2.20和5.26,p < 0.001; 95%可信区间:-4.23,-1.88),减少心理压力(3.00 vs 6.31, t = -4.37, p < 0.001; 95%可信区间:-4.80,-1.81),和更大的满意他们的剂量(42.1%比13.6%,气(2)= 14.44,p < 0.01)。Cronbach's alpha系数为0.76（四个因素维度分别为0.81、0.92、0.94和0.93）。结论：这些发现支持ODAS作为衡量和评估阿片类药物依赖治疗方案中丁丙诺啡剂量充分性的工具的有效性和可靠性。
Objective: The Opiate Dosage Adequacy Scale (ODAS) is a clinical tool to individually measure the "adequacy" of opioid doses in patients on maintenance treatment. The aim of this paper is to provide evidence for the validity and reliability of the ODAS in a sample of patients in buprenorphine/naloxone (B/N) maintenance treatment.Method: Cross-sectional study of a convenience sample of B/N-treated patients (n = 316) from four Autonomous Communities in Spain. Participants completed a battery of instruments to assess the following: buprenorphine dose adequacy; heroin dependence severity; psychological adjustment; and patient-desired adjustment of buprenorphine dose.Results: Exploratory Factor Analysis identified four factors from the ODAS that together account for 85.4% of the total variance: "Heroin craving and use"; "Overmedication"; "Objective opiate withdrawal symptoms (OWS)" and 'Subjective OWS'. Compared to patients with an "inadequate" B/N dose (ODAS), patients with "adequate" doses had less heroin use in the last week (0.01 vs. 0.40; t = -2.73; p < 0.01, 95% CI: -0.67, -0.10), less severe heroin dependence (2.20 vs. 5.26, t = 5.14, p < 0.001; 95% CI: -4.23, -1.88), less psychological distress (3.00 vs. 6.31, t = -4.37, p < 0.001; 95% CI: -4.80, -1.81), and greater satisfaction with their doses (42.1% vs. 13.6%, chi(2) = 14.44, p < 0.01). Cronbach's alpha coefficient was 0.76 (0.81, 0.92, 0.94, and 0.93, respectively, for the four factor dimensions).Conclusion: These findings support the validity and reliability of the ODAS as a tool to measure and assess buprenorphine dose adequacy in the context of an opioid dependency treatment program.