诊所优化梅他治疗阿片类药物使用障碍 (COMET) 的家用药物:为一个阶梯随机试验的协议,以促进临床水平的变化
Sugy Choi1, Megan A O'Grady2, Charles M Cleland1
1Department of Population Health, New York University Grossman School of Medicine, New York City, NY, United States of America.
PloS one
|June 9, 2023
概括
在COVID-19公共卫生紧急情况 (PHE) 期间允许带回家的甲 (THD) 的监管变化可以改善护理. 这项研究开发和测试了一种干预措施,以帮助阿片类药物治疗计划 (OTP) 有效地实施这些拯救生命的THD规则,特别是对于黑人和拉丁裔患者.
科学领域:
- 实施科学 实施科学
- 公共卫生 公共卫生
- 成 药物 药物 药物 药物
背景情况:
- 在COVID-19公共卫生紧急情况 (PHE) 期间,对家用甲剂量 (THD) 的监管灵活性为增强阿片类药物使用障碍 (OUD) 治疗提供了机会.
- 有必要研究这些与PHE相关的THD规则的长期影响,并制定干预措施,以便在阿片类药物治疗计划 (OTP) 中有效采用.
研究的目的:
- 开发和测试OTP的多维干预措施,以解决THD实施的障碍.
- 利用国家行政数据和定性见解,为OTPs创建数据驱动工具.
- 检查对THD使用,在护理中的保留和不良医疗保健事件的干预影响,重点关注黑人和拉丁裔客户的健康平等.
主要方法:
- 一个两阶段的项目,在第一阶段使用解释性的顺序混合方法设计,将行政数据分析与定性采访相结合.
- 一个为期三年的阶段性结试验,其中36名OTP被随机分为队列,在第二阶段进行为期六个月的临床级干预.
- 同步三角测量混合方法设计,用于集成的定量和定性数据分析,使用通用线性混合模型 (GLMMs) 进行阶段形试验分析.
主要成果:
- 该干预措施由健康公平实施框架 (HEIF) 提供信息,将使用混合方法数据开发.
- 阶梯试验将评估干预措施对THD使用,患者保留和医疗保健事件的影响.
- 分析将专门研究黑人和拉丁裔患者群体的差异性干预效应.
结论:
- 该项目解决了在PHE相关的监管转变之后,在甲治疗中持续改变实践的需要.
- 开发的干预措施旨在增加THD的OTP灵活性,提高护理质量和公平性.
- 调查结果将提供证据,为当地和国家层面的政策提供有关美沙带回家剂量的信息.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
349
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
349
Drug Therapy
74
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
74
Drug Dependence
1.1K
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
1.1K
Drug Dosage Regimen: Overview
3.6K
A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
3.6K
Opioid Analgesics: Morphine and Other Natural Cogeners
305
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
305
Analgesia and Pain Management
669
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
669


