Adjunct interventions to standard medical management of buprenorphine in outpatient settings: A systematic review of the evidence.
Adjunct interventions to standard medical management of buprenorphine in outpatient settings: A systematic review of the evidence.
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DOI：
10.1016/j.drugalcdep.2021.108923
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发表时间：
2021-11-01
影响因子：
4.2
通讯作者：
Lovejoy, Travis I.
中科院分区：
文献类型：
--
作者：
Wyse, Jessica J.;Morasco, Benjamin J.;Dougherty, Jacob;Edwards, Beau;Kansagara, Devan;Gordon, Adam J.;Korthuis, P. Todd;Tuepker, Anais;Lindner, Stephan;Mackey, Katherine;Williams, Beth;Herreid-O'Neill, Anders;Paynter, Robin;Lovejoy, Travis I.
越来越多的研究检查了辅助干预措施，以支持接受丁丙诺啡治疗阿片类药物使用障碍 (OUD) 的患者参与和保留治疗。我们对文献进行了系统回顾，探讨了在门诊环境中与丁丙诺啡标准医疗管理一起提供的辅助干预措施对主要结果的影响。我们纳入了前瞻性研究，检查成人在门诊接受丁丙诺啡并配合辅助干预治疗 OUD。数据来源包括 Medline、Cochrane 对照试验中央注册库、CINAHL 和 PsycINFO（从开始到 2020 年 1 月）。两名评估者独立审查全文文章、摘要数据并评估偏倚风险。检查的结果包括戒断、坚持治疗和非成瘾相关的健康结果。最终审查包括 20 篇手稿、11 项随机对照试验 (RCT)、三项 RCT 二次分析和六项观察性研究。大多数研究考察了心理社会干预措施（n = 14）。很少有人研究补充疗法（例如瑜伽；n = 2）或技术干预措施（例如电子药丸分配；n = 3）；一项研究检验了解决护理结构性障碍的干预措施（患者导航员；n = 1）。低偏倚风险随机对照试验发现，没有证据表明在丁丙诺啡治疗中添加心理社会干预措施可以改善药物使用结果。需要研究来确定辅助干预措施，以支持接受丁丙诺啡治疗的患者的药物依从性和成瘾相关结果。临床试验的数据表明，缺乏现成的心理社会治疗手段不应阻止临床医生开出丁丙诺啡处方。
A growing body of research has examined adjunctive interventions supportive of engagement and retention in treatment among patients receiving buprenorphine for opioid use disorder (OUD). We conducted a systematic review of the literature addressing the effect on key outcomes of adjunctive interventions provided alongside standard medical management of buprenorphine in outpatient settings. We included prospective studies examining adults receiving buprenorphine paired with an adjunctive intervention for the treatment of OUD in an outpatient setting. Data sources included Medline, Cochrane Central Register of Controlled Trials, CINAHL and PsycINFO from inception through January 2020. Two raters independently reviewed full-text articles, abstracted data and appraised risk of bias. Outcomes examined included abstinence, retention in treatment and non-addiction-related health outcomes. The final review includes 20 manuscripts, 11 randomized control trials (RCTs), three secondary analyses of RCTs and six observational studies. Most studies examined psychosocial interventions (n = 14). Few examined complementary therapies (e.g., yoga; n = 2) or technological interventions (e.g., electronic pill dispensation; n = 3); one study examined an intervention addressing structural barriers to care (patient navigators; n = 1). Low risk of bias RCTs found no evidence that adding psychosocial interventions to buprenorphine treatment improves substance use outcomes. Research is needed to identify adjunctive interventions with potential to support medication adherence and addiction-related outcomes for patients engaged in buprenorphine treatment. Data from clinical trials suggest that lack of ready access to psychosocial treatments should not discourage clinicians from prescribing buprenorphine.
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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：
168.9
作者：
Degenhardt, Louisa;Grebely, Jason;Larney, Sarah
通讯作者：
Larney, Sarah
影响因子：
4.2
作者：
Chawarski, M. C.;Mazlan, M.;Schottenfeld, R. S.
通讯作者：
Schottenfeld, R. S.
影响因子：
3.9
作者：
Galanter, M;Dermatis, H;Rahman-Dujarric, C
通讯作者：
Rahman-Dujarric, C
优化妈妈的怀孕治疗干预措施（Opti-Mom）：一项试点研究。
影响因子：
5.5
作者：
Cochran GT;Hruschak V;Abdullah W;Krans E;Douaihy AB;Bobby S;Fusco R;Tarter R
通讯作者：
Tarter R