在初级保健机构中预测阿片类药物使用障碍患者中的布普伦诺芬坚持
Stephanie A Hooker1, Colleen Starkey2, Gavin Bart3
1HealthPartners Institute, Research and Evaluation Division, 8170 33rd Ave S, Mail stop 21112R, Minneapolis, MN, 55425, USA. stephanie.a.hooker@healthpartners.com.
BMC primary care
|October 11, 2024
概括
在初级保健中,阿片类药物使用障碍 (OUD) 的布普伦诺芬坚持是低的,不到一半的患者坚持. 男性性别和意外的阳性阿片类药物测试与较低的坚持有关,而前吸烟与更高的坚持有关.
科学领域:
- 药理学和成医学 药理学和成医学
- 初级保健研究研究初级保健研究
- 医疗保健服务研究 医疗服务研究
背景情况:
- 对阿片类药物使用障碍 (MOUD) 的药物,如布普伦诺芬,是对阿片类药物使用障碍 (OUD) 的有效治疗方法.
- 布普伦诺芬在初级保健中越来越多地被处方,但遵守可能是一个挑战.
- 了解坚持率和相关因素对于在门诊环境中优化OUD治疗至关重要.
研究的目的:
- 为了确定在治疗的前六个月内OUD患者中布普伦诺芬坚持率.
- 为了确定与布普伦诺啡因坚持相关的人口,服务和临床因素.
主要方法:
- 从345名OUD患者的电子健康记录 (EHR) 进行了回顾性分析,这些患者是新开始服用布诺芬的.
- 坚持定义为在六个月内覆盖日数比例 (PDC) ≥80%.
- 后勤回归用于检查与坚持相关的因素.
主要成果:
- 只有44%的患者实现了布普伦诺芬坚持 (PDC ≥80%).
- 男性性别 (OR=0.34) 和意想不到的阿片类药物尿液毒理学结果 (OR=0.42) 与较低的坚持相关.
- 前吸烟者 (OR=1.82) 与目前吸烟者相比,吸烟的坚持率更高.
结论:
- 在OUD的初级保健中,布普伦诺芬的坚持可能是次优的.
- 男性的性别和吸烟状态是影响坚持的重要因素.
- 需要进一步的研究来阐明这些关联背后的机制,并改善治疗结果.
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