A comparison of buprenorphine induction strategies: patient-centered home-based inductions versus standard-of-care office-based inductions.
A comparison of buprenorphine induction strategies: patient-centered home-based inductions versus standard-of-care office-based inductions.
复制标题
丁丙诺啡诱导策略的比较：以患者为中心的家庭归纳与护理标准的基于办公室的归纳。
DOI：
10.1016/j.jsat.2010.12.002
复制
发表时间：
2011-06
影响因子：
3.9
通讯作者：
Sohler NL
中科院分区：
文献类型：
--
作者：
Cunningham CO;Giovanniello A;Li X;Kunins HV;Roose RJ;Sohler NL
虽然新的丁丙诺啡诱导策略正在出现，但它们还没有得到充分的研究。为了检验我们新开发的以患者为中心的家庭诱导，我们对79名在城市社区卫生中心进行丁丙诺啡诱导的阿片类药物依赖个体进行了亚组分析。被试选择归纳策略；以办公室为基础的标准诱导是由医生驱动的，有多种评估和观察，而以患者为中心的以家庭为基础的诱导强调患者的自我管理，并包括一个在家诱导的“工具包”。我们进行了采访，提取了医疗记录。使用混合非线性模型，我们检查了诱导策略与阿片类药物使用和任何药物使用之间的关系。与以标准护理为基础的办公室诱导相比，以患者为中心的家庭诱导的参与者在阿片类药物使用方面没有显著差异（AOR=0.63, 95%CI= 0.13-2.97），但在任何药物使用方面都有较大的减少（AOR=0.05, 95%CI= 0.01-0.37）。考虑到我们的观察性队列研究设计的局限性，我们得出结论，与标准护理办公室诱导相比，以患者为中心的家庭诱导的参与者在阿片类药物使用方面有相似的减少，在任何药物使用方面都有更大的减少。新的归纳策略必须建立在现有模型或理论的基础上，并得到充分的研究。
Although novel buprenorphine induction strategies are emerging, they have been inadequately studied. To examine our newly developed patient-centered home-based inductions, we conducted a subgroup analysis of 79 opioid-dependent individuals who had buprenorphine inductions at an urban community health center. Participants chose their induction strategy; standard-of-care office-based inductions were physician-driven, with multiple assessments, and observed, and patient-centered home-based inductions emphasized patient self-management and included a “kit” for induction at home. We conducted interviews and extracted medical records. Using mixed non-linear models, we examined associations between induction strategy and opioid use and any drug use. Compared to those with standard-of-care office-based inductions, participants with patient-centered home-based inductions had no significant differences in opioid use (AOR=0.63, 95%CI=0.13–2.97), but greater reductions in any drug use (AOR=0.05, 95%CI=0.01–0.37). Taking into account the limitations of our observational cohort study design, we conclude that participants with patient-centered home-based inductions had similar reductions in opioid use and greater reductions in any drug use than those with standard-of-care office-based inductions. It is essential that new induction strategies be based on existing models or theories and well-studied.