Global opioid agonist treatment: a review of clinical practices by country.
Global opioid agonist treatment: a review of clinical practices by country.
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DOI：
10.1111/add.15087
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Larney S
中科院分区：
文献类型：
--
作者：
Jin H;Marshall BDL;Degenhardt L;Strang J;Hickman M;Fiellin DA;Ali R;Bruneau J;Larney S
我们评估了阿片类药物使用障碍（OUD）的阿片类激动剂治疗（OAT），特别是美沙酮和丁丙诺啡，包括丁丙诺啡-纳洛酮，如何在常规临床实践中提供，重点关注影响这些服务的获得和提供的因素。本综述的目的是总结入组OAT的合格标准、常规临床实践中的剂量、无监督给药的获得和合格性以及全球OAT项目中的尿液药物筛查实践。我们完成了PubMed、Embase和灰色文献数据库中关于使用美沙酮或丁丙诺啡的OAT横断面或观察性队列研究的检索。将从合格研究中提取的剂量数据与世卫组织提供的指南进行比较。我们发现来自41个国家的140份报告至少包含一项相关指标的数据。类阿片依赖或类阿片使用障碍的诊断是OAT最常见的资格要求（13或17个国家）。报告的美沙酮的平均或中位剂量范围为16 - 131 mg，而丁丙诺啡的范围为2.5 - 19 mg。27个国家中有18个国家报告说，在某些条件下可以在无人监督的情况下服药。定期尿液药物筛查（UDS）的频率范围从每周几次到每年八次（美沙酮）或根据临床指征。类阿片激动剂治疗做法，包括处方剂量，在各国内部和各国之间差异很大。特别令人关注的是持续存在的低剂量处方做法，其中患者的处方剂量可能低于已证明可产生显著临床益处的剂量。
We assessed how opioid agonist treatment (OAT) for opioid use disorder (OUD), specifically methadone and buprenorphine, including buprenorphine-naloxone, is delivered in routine clinical practice, with a focus on factors that affect access to and delivery of these services. The aims of this review were to summarize eligibility criteria for entry to OAT, doses in routine clinical practice, access to and eligibility for unsupervised dosing, and urine drug screening practices in OAT programs globally. We completed searches of PubMed, Embase, and grey literature databases for cross-sectional or observational cohort studies of OAT using either methadone or buprenorphine. Dose data extracted from eligible studies were compared with guidelines provided by WHO. We found 140 reports from 41 countries that contained data for at least one of the relevant indicators. A diagnosis of opioid dependence or opioid use disorder was the most common eligibility requirement for OAT (13 or 17 countries). Reported mean or median doses for methadone ranged from 16 to 131 mg while range for buprenorphine was 2.5 – 19 mg. Access to unsupervised dosing under some conditions was reported in 18 of 27 countries. Frequency of regular urine drug screenings (UDS) ranged from several times a week to eight times per year (methadone) or as clinically indicated. Opioid agonist treatment practices, including doses prescribed, vary greatly both within and across countries. Of particular concern is the persistence of lower dose prescribing practices, in which patients may be prescribed doses below those proven to yield significant clinical benefits.
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影响因子：
3.9
作者：
Lawental, Maayan
通讯作者：
Lawental, Maayan
DOI：
10.1136/bmj.e5945
发表时间：
2012-10-03
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
MacArthur GJ;Minozzi S;Martin N;Vickerman P;Deren S;Bruneau J;Degenhardt L;Hickman M
通讯作者：
Hickman M
影响因子：
4.2
作者：
Dunlop, Adrian J.;Brown, Amanda L.;Lintzeris, Nicholas
通讯作者：
Lintzeris, Nicholas
DOI：
10.1016/s2214-109x(17)30373-x
发表时间：
2017-12
期刊：
The Lancet. Global health
影响因子：
--
作者：
Larney S;Peacock A;Leung J;Colledge S;Hickman M;Vickerman P;Grebely J;Dumchev KV;Griffiths P;Hines L;Cunningham EB;Mattick RP;Lynskey M;Marsden J;Strang J;Degenhardt L
通讯作者：
Degenhardt L
影响因子：
5.7
作者：
Calcaterra, S. L.;Bach, P.;Samet, J. H.
通讯作者：
Samet, J. H.