住院后坚持服用纳曲酮治疗酒精使用障碍的相关因素。

IF 3.9 2区 医学 Q1 PSYCHIATRY
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引用次数: 0

摘要

简介:住院为酒精使用障碍(AUD)患者提供了开始使用纳曲酮的机会。了解与住院后依从性相关的因素可为实践提供参考:本研究是对一项临床试验进行的二次分析,在该试验中,AUD 患者在出院时随机接受口服 (PO) 和长效注射 (LAI) 纳曲酮治疗。这项二次分析的结果是出院 3 个月后的纳曲酮依从性,即每月 3 次注射中至少接受 2 次注射,或自我报告的口服药物使用天数达到同等水平(90 天中的 60 天)。我们利用基线社会人口统计学、药物使用史、健康状况、医疗保健使用情况和随机分组构建了多变量逻辑回归模型,以确定依从性的相关因素:我们对开始接受纳曲酮治疗的患者进行了评估,其中124人随机接受了PO治疗,120人接受了LAI治疗(总平均年龄为49岁,80%为男性,51%为黑人,47%无住房,91%患有严重的AUD)。3 个月后,50% 的患者坚持治疗。LAI 纳曲酮(aOR 3.88;95 % CI 2.17-7.13)、近期就诊(aOR 2.01;95 % CI 1.10-3.72)和年龄(aOR 每 10 年增加 1.37;95 % CI 1.02-1.88)与坚持治疗的几率增加有关。未居住状态(aOR 0.54;95 % CI 0.30-0.98)和可卡因使用(aOR 0.35;95 % CI 0.17-0.71)与坚持治疗的几率下降有关:结论:出院时接受 LAI 纳曲酮治疗 AUD 与服用 PO 相比,3 个月的依从性更好。对使用可卡因或无家可归的患者提供 LAI 纳曲酮和有针对性的干预措施有望提高纳曲酮的依从性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Correlates of post-hospitalization naltrexone adherence for alcohol use disorder

Introduction

Hospitalizations present an opportunity to initiate naltrexone for patients with alcohol use disorder (AUD). Understanding factors associated with post-hospitalization adherence could inform practice.

Methods

This study is a secondary analysis of a clinical trial in which patients with AUD were randomized to oral (PO) versus long-acting injectable (LAI) naltrexone at hospital discharge. The outcome of this secondary analysis was naltrexone adherence 3 months after discharge, defined as receipt of at least 2 out of 3 monthly injections or the equivalent days of self-reported PO medication use (60 out of 90). We used baseline socio-demographics, substance use history, health status, healthcare utilization, and randomization arm to construct multivariable logistic regression models to identify correlates of adherence.

Results

We evaluated patients who initiated naltrexone treatment, 124 randomized to PO and 120 to LAI (overall mean age 49 years, 80 % male, 51 % Black, 47 % unhoused, and 91 % with severe AUD). At 3 months, 50 % of patients were adherent. LAI naltrexone (aOR 3.88; 95 % CI 2.17–7.13), recent office visit (aOR 2.01; 95 % CI 1.10–3.72), and age (aOR per 10-year increase 1.37; 95 % CI 1.02–1.88) were associated with increased odds of adherence. Unhoused status (aOR 0.54; 95 % CI 0.30–0.98) and cocaine use (aOR 0.35; 95 % CI 0.17–0.71) were associated with decreased odds of adherence.

Conclusions

LAI naltrexone for AUD at hospital discharge was associated with better adherence at 3 months vs PO. Access to LAI naltrexone and targeted interventions for patients with cocaine use or who are unhoused hold potential to improve naltrexone adherence.
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来源期刊
Drug and alcohol dependence
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.
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