在第一民族人民中保持阿片类药物激动剂治疗
Alice Holton1,2,3, Bisola Hamzat1,2, Daniel McCormack4
1Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
JAMA network open
|June 30, 2025
概括
在安大略省的第一民族人群中,阿片类药物agonist疗法 (OAT) 的保留率较低. 随着时间的推移,甲保留率下降,突出显示需要文化相关的,由第一民族领导的治疗计划来应对阿片类药物危机.
科学领域:
- 公共卫生 公共卫生
- 成 药物 药物 药物 药物
- 土著健康土著健康
背景情况:
- 加拿大的第一民族人面临着阿片类药物危机带来的不成比例的影响.
- 了解影响早期停止阿片类药物激动剂治疗 (OAT) 的因素对于改善治疗结果至关重要.
研究的目的:
- 调查加拿大安大略省第一民族人在治疗的第一年内与OAT保留相关的因素.
- 为了比较甲和布普伦诺芬-纳洛治疗之间的保留率.
主要方法:
- 在2013年至2021年期间,对15岁以上的注册第一民族个人进行了OAT (甲或布普伦诺芬-纳洛) 的基于人口的回顾性队列研究.
- 考克斯的比例危险模型被用来分析OAT停止的时间,定义为>14天的间隔.
主要成果:
- 总共分析了17880个OAT启动. 与甲 (平均71天) 相比,布普伦诺芬-纳洛的治疗持续时间较短 (平均42天).
- 与更好的保留相关的因素包括居住在城市地区和最近使用非OAT阿片类药物.
- 与更高的戒断率相关的因素包括最近的阿片类药物毒性事件和以前的甲治疗. 随着时间的推移,甲的停用增加了,与布普伦诺芬-纳洛不同.
结论:
- 在安大略省的第一民族人群中观察到低OAT保留率.
- 虽然甲的初始保留率较高,但其有效性随着时间的推移而下降,这表明OAT供应存在重大差距.
- 建议投资于由第一民族领导的治疗计划,整合传统和陆地方法,以改善对阿片类药物使用障碍患者的支持.
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