Integrating Cognitive Dysfunction Accommodation Strategies Into Behavioral Interventions for Persons on Medication for Opioid Use Disorder.
Integrating Cognitive Dysfunction Accommodation Strategies Into Behavioral Interventions for Persons on Medication for Opioid Use Disorder.
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DOI：
10.3389/fpubh.2022.825988
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发表时间：
2022
影响因子：
5.2
通讯作者：
Copenhaver MM
中科院分区：
文献类型：
--
作者：
Mistler CB;Idiong CI;Copenhaver MM
认知功能障碍在阿片类药物使用障碍（OUD）患者中尤为普遍。特定领域的认知功能障碍（注意力、执行功能、记忆和信息处理）可能显著影响OUD （mod）药物治疗患者的治疗结果。这限制了患者在行为干预过程中学习、记忆和应用信息的能力。基于证据的适应策略已被整合到与OUD患者认知概况相似的其他患者群体的行为干预中；然而，这些策略的可行性和有效性尚未在药物治疗环境中的mod患者中进行测试。我们在康涅狄格州纽黑文的一个药物治疗项目中对25名关键线人（10名药物治疗提供者和15名服用mod的患者）进行了一系列的焦点小组研究。采用归纳方法，我们研究了认知功能障碍如何阻碍参与者在药物治疗背景下保留、回忆和利用艾滋病毒预防信息的能力。两个主要主题反映了关键信息提供者的总体反应：(1)认知功能障碍问题和(2)适应策略建议。适应策略的分主题涉及关于特定循证策略的建议，这些策略应纳入对吸毒成瘾者的行为干预措施。具体的调整策略包括：使用书面议程、正念冥想、多模式信息展示、实践演示以及会议的正式结束/总结。补偿认知功能障碍的调节策略得到了mod治疗提供者和患者的认可。这些调节策略有可能提高行为干预的有效性，以减少吸毒人员之间的艾滋病毒传播，以及成瘾严重程度和过量。
Cognitive dysfunction is disproportionately prevalent among persons with opioid use disorder (OUD). Specific domains of cognitive dysfunction (attention, executive functioning, memory, and information processing) may significantly impede treatment outcomes among patients on medication for OUD (MOUD). This limits patient's ability to learn, retain, and apply information conveyed in behavioral intervention sessions. Evidence-based accommodation strategies have been integrated into behavioral interventions for other patient populations with similar cognitive profiles as persons with OUD; however, the feasibility and efficacy of these strategies have not yet been tested among patients on MOUD in a drug treatment setting. We conducted a series of focus groups with 25 key informants (10 drug treatment providers and 15 patients on MOUD) in a drug treatment program in New Haven, CT. Using an inductive approach, we examined how cognitive dysfunction impedes participant's ability to retain, recall, and utilize HIV prevention information in the context of drug treatment. Two main themes capture the overall responses of the key informants: (1) cognitive dysfunction issues and (2) accommodation strategy suggestions. Subthemes of accommodation strategies involved suggestions about particular evidence-based strategies that should be integrated into behavioral interventions for persons on MOUD. Specific accommodation strategies included: use of a written agenda, mindfulness meditation, multi-modal presentation of information, hands-on demonstrations, and a formal closure/summary of sessions. Accommodation strategies to compensate for cognitive dysfunction were endorsed by both treatment providers and patients on MOUD. These accommodation strategies have the potential to enhance the efficacy of behavioral interventions to reduce HIV transmission among persons on MOUD as well as addiction severity, and overdose.
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DOI：
10.7748/ns.23.23.42.s50
发表时间：
2009-02-11
影响因子：
--
作者：
Jootun, Dev;McGhee, Gerry;Marland, Glenn R
通讯作者：
Marland, Glenn R
DOI：
10.1016/s0140-6736(10)60829-x
发表时间：
2010-07-31
期刊：
Lancet (London, England)
影响因子：
--
作者：
Altice FL;Kamarulzaman A;Soriano VV;Schechter M;Friedland GH
通讯作者：
Friedland GH
影响因子：
1.7
作者：
Ezeabogu I;Copenhaver MM;Potrepka J
通讯作者：
Potrepka J
影响因子：
2.3
作者：
Copenhaver, Michael M.;Sanborn, Victoria;Gunstad, John
通讯作者：
Gunstad, John
DOI：
10.1097/01.qai.0000140605.51640.5c
发表时间：
2004-10-01
影响因子：
3.6
作者：
Fisher, JD;Cornman, DH;Friedland, GA
通讯作者：
Friedland, GA