Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: A pilot randomized controlled trial.
Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: A pilot randomized controlled trial.
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DOI：
10.1371/journal.pone.0183354
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Vittinghoff E
中科院分区：
文献类型：
--
作者：
Coffin PO;Santos GM;Matheson T;Behar E;Rowe C;Rubin T;Silvis J;Vittinghoff E
美国正处于阿片类药物流行之中，包括可能导致快速死亡的合成阿片类药物，使旁观者获救的机会微乎其微。我们试行了一种行为干预措施，以减少阿片类药物依赖者中阿片类药物过量的发生，这些人是随后过量服药的高危人群。我们在旧金山公共卫生部进行了一项单盲随机对照试验，从2014年到2016年，在16个月的时间里，重复剂量激励性访谈干预(REBOOT)旨在减少过量用药与常规治疗相比，定义为信息和转诊。参与者年龄在18-65岁之间，通过结构化临床访谈有阿片类药物使用障碍，积极使用阿片类药物，5年内阿片类药物过量，并事先收到纳洛酮药盒。干预在0、4、8和12个月进行，在此之前的评估也在16个月进行。双重主要结果是通过计算机辅助个人访谈收集的任何过量事件和事件数量，以及根据生命记录收集的任何致命的过量事件。共筛选78人，报名63人。平均年龄为43岁，其中67%出生时为男性，65%为白人，17%为非裔美国人，14%为拉丁裔。92%的探视和93%的咨询课程已经完成。在基线时，33.3%的参与者在过去四个月中经历过服药过量，两组患者的平均服药过量次数相似(p=0.95)；29%的受试者在随访期间服药过量。通过意向治疗，被分配到重启的参与者不太可能经历任何过量服药(发生率比[IRR0.62[95%CI0.41-0.92，p=0.019])和经历更少的过量事件(IRR0.46，95%CI0.24-0.90，p=0.023)，这些结果对敏感性分析是强有力的。在阿片类药物使用、物质使用治疗或纳洛酮运输的天数方面，武器之间没有差异。重新启动减少了任何阿片类药物过量的发生和过量的数量。ClinicalTrials.gov NCT02093559
The United States is amidst an opioid epidemic, including synthetic opioids that may result in rapid death, leaving minimal opportunity for bystander rescue. We pilot tested a behavioral intervention to reduce the occurrence of opioid overdose among opioid dependent persons at high-risk for subsequent overdose. We conducted a single-blinded randomized-controlled trial of a repeated dose motivational interviewing intervention (REBOOT) to reduce overdose versus treatment as usual, defined as information and referrals, over 16 months at the San Francisco Department of Public Health from 2014–2016. Participants were 18–65 years of age, had opioid use disorder by Structured Clinical Interview, active opioid use, opioid overdose within 5 years, and prior receipt of naloxone kits. The intervention was administered at months 0, 4, 8, and 12, preceded by the assessment which was also administered at month 16. Dual primary outcomes were any overdose event and number of events, collected by computer-assisted personal interview, as well as any fatal overdose events per vital records. A total of 78 persons were screened and 63 enrolled. Mean age was 43 years, 67% were born male, 65% White, 17% African-American, and 14% Latino. Ninety-two percent of visits and 93% of counseling sessions were completed. At baseline, 33.3% of participants had experienced an overdose in the past four months, with a similar mean number of overdoses in both arms (p = 0.95); 29% overdosed during follow-up. By intention-to-treat, participants assigned to REBOOT were less likely to experience any overdose (incidence rate ratio [IRR] 0.62 [95%CI 0.41–0.92, p = 0.019) and experienced fewer overdose events (IRR 0.46, 95%CI 0.24–0.90, p = 0.023), findings that were robust to sensitivity analyses. There were no differences between arms in days of opioid use, substance use treatment, or naloxone carriage. REBOOT reduced the occurrence of any opioid overdose and the number of overdoses. clinicaltrials.gov NCT02093559
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DOI：
10.1111/add.13265
发表时间：
2016-05
期刊：
Addiction (Abingdon, England)
影响因子：
--
作者：
Bird SM;McAuley A;Perry S;Hunter C
通讯作者：
Hunter C
影响因子：
4.2
作者：
Darke, Shane;Mills, Katherine L.;Teesson, Maree
通讯作者：
Teesson, Maree
影响因子：
6
作者：
Coffin, PO;Galea, S;Tardiff, K
通讯作者：
Tardiff, K
影响因子：
120.7
作者：
Kamb, ML;Fishbein, M;Peterman, TA
通讯作者：
Peterman, TA
影响因子：
5
作者：
Evans, Jennifer L.;Tsui, Judith I.;Page, Kimberly
通讯作者：
Page, Kimberly