A randomized pilot clinical trial to evaluate the efficacy of Community Reinforcement and Family Training for Treatment Retention (CRAFT-T) for improving outcomes for patients completing opioid detoxification
A randomized pilot clinical trial to evaluate the efficacy of Community Reinforcement and Family Training for Treatment Retention (CRAFT-T) for improving outcomes for patients completing opioid detoxification
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DOI：
10.1016/j.drugalcdep.2014.02.013
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发表时间：
2014-05-01
影响因子：
4.2
通讯作者：
Somoza, Eugene
中科院分区：
文献类型：
--
作者：
Brigham, Gregory S.;Slesnick, Natasha;Somoza, Eugene
背景资料：通过心理社会咨询进行的去精神病化仍然是标准的阿片类药物使用障碍治疗实践，但结果不佳。本研究测试了一个新开发的社会心理干预，社区强化方法和家庭训练的治疗保留（CRAFT-T），相对于社会心理治疗照常（TAU），为改善治疗outcomes.Methods的疗效：一个随机，14周的试验，在6个月和9个月后随机进行的后续访问在两个物质使用障碍（SUD）的治疗方案。阿片类依赖成人（即，将登记在住宅丁丙诺啡解毒计划中并且其确定的相关重要他人（CSO）的确定的患者IF）随机分配至CRAFT-T（n =28对）或TAU（n = 24对）。CRAFT-T包括两次与联合会和民间社会组织一起举行的会议和10次单独与民间社会组织举行的会议，为期14周。对民间社会组织而言，技术援助股主要是教育性的，并介绍自助。所有IP均接受其入组的SUD项目通常提供的治疗。主要结局为至首次IP从治疗中脱落持续30天或以上的时间。阿片类药物和其他药物的使用是关键的次要结局。结果：CRAFT-T对治疗保留产生了中度但不显着的影响（p = 0.058，风险比= 0.57）。当C50是亲本家族时，CRAFT-T对治疗保持有很大且显著的影响（p < 0.01，风险比= 0.040）。结论：CRAFT-T治疗阿片类药物使用障碍具有良好的临床应用前景，但仍需临床重复研究证实。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Background: Detoxification with psychosocial counseling remains a standard opioid-use disorder treatment practice but is associated with poor outcomes. This study tested the efficacy of a newly developed psychosocial intervention, Community Reinforcement Approach and Family Training for Treatment Retention (CRAFT-T), relative to psychosocial treatment as usual (TAU), for improving treatment outcomes.Methods: A randomized, 14-week trial with follow-up visits at 6 and 9 months post-randomization conducted at two substance use disorder (SUD) treatment programs. Opioid-dependent adults (i.e., identified patient IF) enrolled in a residential buprenorphine-detoxification program and their identified concerned significant other (CSO) was randomized to CRAFT-T (n =28 dyads) or TAU (n = 24 dyads). CRAFT-T consisted of two sessions with the IF and CSO together and 10 with the CSO alone, over 14 weeks. TAU for the CSOs was primarily educational and referral to self-help. All IPs received treatment as usually provided by the SUD program in which they were enrolled. The primary outcome was time to first IP drop from treatment lasting 30 days or more. Opioid and other drug use were key secondary outcomes.Results: CRAFT-T resulted in a moderate but non-significant effect on treatment retention (p = 0.058, hazard ratio= 0.57). When the C50 was parental family, CRAFT-T had a large and significant effect on treatment retention (p < 0.01, hazard ratio =.040). CRAFT-T had a significant positive effect on IP opioid and other drug use (p < 0.0001).Conclusion: CRAFT-T is a promising treatment for opioid use disorder but replication is needed to confirm these results. (C) 2014 Elsevier Ireland Ltd. All rights reserved.