美沙酮治疗参与者中未使用阿片类药物、使用阿片类药物和随后退出治疗之间的变量和转变之间的关系:利用多州模型进行的回顾性研究。

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE
Boyu Li, Chijie Wang, Xijia Tang, Zouxiang Chen, Zhiyao Li, Wensu Zhou, Wen Chen, Li Ling
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引用次数: 0

摘要

背景:尽管之前的研究已经报道了影响接受美沙酮治疗者使用阿片类药物或辍药的变量,但对不使用阿片类药物、使用阿片类药物和辍药之间过渡的相关变量关注有限:这项回顾性研究利用了 2010 年 6 月至 2022 年 6 月期间在中国广东省 11 家美沙酮治疗诊所收集的数据。根据每月的尿液吗啡检测结果和每天的美沙酮摄入记录,定义了两种瞬时状态(未使用阿片类药物和使用阿片类药物)和一种吸收状态(退出)。我们使用一个多状态模型来探讨与参与者中未使用阿片类药物、使用阿片类药物和辍学之间的过渡相关的变量:在平均治疗时间为 497 天的 3136 名参与者中,有 1646 人(52.49%)至少使用过一次阿片类药物,结果有 3283 人从未用过阿片类药物过渡到使用过阿片类药物。不使用阿片类药物和使用阿片类药物之间的转变与年龄、性别、就业状况、婚姻状况、居住环境、前往诊所的交通时间、人体免疫缺陷病毒和丙型肝炎病毒感染状况、美沙酮平均用量和出勤率等变量有显著关联。影响参与者辍学的变量因其阿片类药物使用行为而异。此外,在一个确定的时间点,特定阿片类药物使用状态保持不变或过渡到不同状态的概率也会随着时间的推移而变化:结论:参与者使用阿片类药物的行为是动态的。美沙酮提供者应根据参与者的阿片类药物使用行为提供有针对性的干预措施,以有效降低阿片类药物使用率并提高保留率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association Between Variables and Transitions Among No Opioid Use, Opioid Use, and Subsequent Dropout Among Participants on Methadone Treatment: A Retrospective Study Utilizing a Multistate Model.

Background: Although previous studies have reported the variables that influence opioid use or dropout among participants receiving methadone treatment, limited attention has been given to the variables related to transitions among no opioid use, opioid use, and dropout.

Methods: This retrospective study utilized data collected from June 2010 to June 2022 at 11 methadone treatment clinics in Guangdong Province, China. Two transient states (no opioid use and opioid use) and 1 absorbing state (dropout) were defined based on monthly urine morphine test results and daily methadone intake records. We used a multistate model to explore the variables associated with transitions among no opioid use, opioid use, and dropout among participants.

Results: Among 3136 participants, with an average treatment duration of 497 days, 1646 (52.49%) underwent at least 1 period of opioid use, resulting in 3283 transitions from no opioid use to opioid use. The transitions between no opioid use and opioid use were significantly associated with variables such as age, gender, employment status, marital status, living situation, travel time to the clinic, human immunodeficiency virus and hepatitis C virus infection statuses, average methadone dosage, and attendance rates. The variables influencing participants' dropout varied depending on their opioid use behaviors. Additionally, the probability of a specified opioid use state remaining unchanged or transitioning to a different state at a defined time point would change over time.

Conclusions: The opioid use behaviors of participants are dynamic. Methadone providers should offer targeted interventions based on participants' opioid use behaviors to effectively decrease rates of opioid use and improve retention.

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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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