门以下阿片类药物使用障碍预防 (STOP) 试验:一个集群随机临床试验:研究设计和方法
Jane M Liebschutz1, Geetha A Subramaniam2, Rebecca Stone3
1Division of General Internal Medicine, Center for Research On Health Care, University of Pittsburgh, 200 Lothrop Street, Suite 933W, Pittsburgh, PA, 15213, USA. liebschutzjm@upmc.edu.
Addiction science & clinical practice
|November 19, 2023
概括
低值阿片类药物使用障碍预防 (STOP) 试验测试了一种协作护理干预措施,以减少初级保健中风险阿片类药物使用. 这种方法旨在防止进展到中度或重度阿片类药物使用障碍 (OUD).
科学领域:
- 公共卫生 公共卫生
- 临床干预研究 临床干预研究
- 药物使用障碍 药物使用障碍
背景情况:
- 在低于值的OUD患者中,预防发展为中度或严重的阿片类药物使用障碍 (OUD) 尚不清楚.
- 没有满足当前治疗标准的危险阿片类药物使用需要基于初级保健的有效干预措施.
- 下值阿片类药物使用障碍预防 (STOP) 试验解决了这一知识差距.
研究的目的:
- 为了评估成年初级保健患者的协作护理干预措施的有效性,OUD.
- 为了减少危险的阿片类药物使用,并防止进展到中度或严重的OUD.
- 为可行和有效的初级保健干预提供潜在的蓝图.
主要方法:
- 在5个地理区域进行集群随机对照试验 (RCT),在初级保健提供者 (PCP) 层面随机对照.
- 干预组接受了实践嵌入的护士护理经理,简短的建议和电话健康指导.
- 主要结局:180天内自我报告的危险阿片类药物使用日;每月通过短信进行评估.
主要成果:
- 该研究旨在估计干预组和对照组之间的平均水平差异.
- 二次结果包括其他物质使用,心理健康,生活质量和医疗保健利用.
- 作为次要结果,PCP处方和监测行为也被评估.
结论:
- STOP试验的研究结果将为开发管理有风险的阿片类药物使用患者的干预措施提供信息.
- 这项研究可能为初级保健机构提供一种可行和有效的方法.
- 在预防更严重的物质使用障碍方面,有效管理低于值的OUD至关重要.
更多相关视频
相关概念视频
01:25Analgesia and Pain Management
632
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...
632
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
307
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...
307
01:24Substance Use Disorders Affecting Sleep
173
Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
Understanding the concepts of physical dependence,...
Understanding the concepts of physical dependence,...
173
01:22Opioid Receptors: Overview
916
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
916
01:11Clinical Trials: Overview
3.0K
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
3.0K