心理社会和药理干预问题性甲基胺使用:从文献范围审查的调查结果
Mona Hersi1, Kim Corace1,2,3,4, Candyce Hamel1
1Ottawa Hospital Research Institute, Ottawa, Canada.
PloS one
|October 11, 2023
概括
甲基胺使用障碍 (MUD) 的有效治疗方法仍然不确定. 这次审查发现应急管理和某些药物显示出潜力,但需要更多的研究才能对MUD管理做出明确的建议.
科学领域:
- 成 药物 药物 药物 药物
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 甲基胺使用障碍 (MUD) 和有问题的甲基胺使用 (PMU) 构成重大公共卫生挑战.
- 现有的MUD/PMU的心理社会和药理干预缺乏最佳管理的明确证据.
- 对当前治疗证据的全面概述对于指导临床实践至关重要.
研究的目的:
- 对最近的系统审查,临床实践指南和对MUD/PMU干预措施的初级研究进行范围审查.
- 综合关于MUD/PMU心理社会和药物治疗有效性的证据.
- 识别文献中的空白和未来研究领域.
主要方法:
- 在2022年2月搜索了电子数据库 (MEDLINE,Embase),更新了之前的搜索.
- 采用两阶段选过程,利用人工智能提高效率.
- 包括对MUD/PMU个体的研究,考虑关键子组和各种结果 (使用,复发,伤害,心理健康,保留).
主要成果:
- 确定了2项系统性审查,1项临床实践指南和54项初级研究.
- 系统性审查发现精神兴奋剂或托皮拉对禁欲或渴望没有显著影响.
- 应急管理在心理社会干预中显示出潜在有效性的最一致的证据;布普罗皮安和莫达菲尼尔是常见的药理学药物.
- 几乎所有干预措施都在至少一个结局指标上显示出一些潜在的益处,尽管通常是基于单个研究.
结论:
- 目前对MUD/PMU干预措施的证据在很大程度上是不确定的,因为单个研究评估的普遍性.
- 临床实践指南建议心理社会干预和支持小组用于急性后管理.
- 需要进一步进行高质量的初级研究,持续时间更长,样本更大,专注于特殊人群,以确定MUD/PMU的最终治疗建议.
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