孕期和产后阿片类药物使用障碍（MOUD）治疗成功的相关因素：范围综述。

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2024-09-28 DOI:10.1016/j.drugalcdep.2024.112454

Maureen Mburu , Rita Masese , Elizabeth T. Knippler , Melissa H. Watt , Amnazo Muhirwa , Leila Ledbetter , Margaret Graton , Brandon A. Knettel

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引用次数: 0

摘要

背景：阿片类药物使用障碍（MOUD）药物治疗是对妊娠期和产后阿片类药物使用障碍（OUD）患者的重要干预措施。然而，关于这一人群中阿片类药物使用障碍治疗成功的相关因素的数据却很少。本范围综述旨在评估孕期和产后MOUD治疗成功的相关因素：我们对 MEDLINE、CINAHL、PsycINFO、Web of Science 和 ProQuest 数据库进行了结构化检索。符合条件的研究包括对孕期和产后门诊治疗成功率的衡量标准，并且是在美国食品药品管理局于 2002 年批准丁丙诺啡之后进行的。评审员独立筛选纳入研究并提取数据。主要结果是孕期和产后 12 个月内的治疗成功率（即治疗依从性、戒断非法阿片类药物或继续接受治疗）：结果：纳入了 15 项研究的数据。药物包括美沙酮、纳曲酮和丁丙诺啡（单一疗法或联合疗法）。丁丙诺啡（单一疗法或联合疗法）的日剂量大、开始治疗时间早、MOUD持续时间长与治疗成功有关。涉及法律问题、无家可归和居住在农村与治疗成功与否呈负相关。接受远程医疗与面对面治疗的结果没有差异：我们发现了一些与孕期和产后 OUD 患者的 MOUD 治疗成功率相关的因素。这些因素可能有助于指导未来的研究，并为制定和调整干预措施提供信息，以更好地满足这一关键人群的需求。

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Factors associated with medications for opioid use disorder (MOUD) treatment success during the pregnancy and postpartum periods: A scoping review

Background

Medications for opioid use disorder (MOUD) are a crucial intervention for pregnant and postpartum individuals with opioid use disorder (OUD). However, there is paucity of data on the factors associated with MOUD treatment success in this population. This scoping review aimed to evaluate factors associated with MOUD success during the pregnancy and postpartum period.

Methods

We completed a structured search of MEDLINE, CINAHL, PsycINFO, Web of Science, and ProQuest databases. Eligible studies included a metric of success in outpatient treatment in the pregnancy and postpartum period and were conducted in the United States after the Food and Drug Administration’s approval of buprenorphine in 2002. Reviewers independently screened studies for inclusion and extracted data. The primary outcome was treatment success (i.e., treatment adherence, abstinence from illicit opioids, or retention in care) during pregnancy and up to 12 months postpartum.

Results

Data from 15 studies were included. Medications included methadone, naltrexone and buprenorphine (mono or combination therapy). High daily dose of buprenorphine as mono or combination therapy, early initiation and longer duration of MOUD were associated with treatment success. Legal involvement, homelessness, and rural residency were negatively associated with treatment success. There were no differences in outcomes of individuals receiving telemedicine versus in-person care.

Conclusion

We identified several factors associated with MOUD treatment success among individuals with OUD during the pregnancy and postpartum periods. These factors may help guide future research and inform the development and adaptation of interventions tailored to better meet the needs of this key population.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.