对阿片类药物使用障碍康复患者报告的结果措施进行系统回顾。

IF 5.3 1区 医学 Q1 PSYCHIATRY
Addiction Pub Date : 2025-10-21 DOI:10.1111/add.70212
Jarratt D Pytell, Dennis Pales, Caty Simon, Jarett Beaudoin, Ahmed M Y Osman, Ellie Svoboda, Paul J Christine, Daniel Matlock, Robert Schwartz, Ingrid A Binswanger
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引用次数: 0

摘要

背景和目的:以恢复为重点的阿片类药物使用障碍(OUD)基于测量的护理可以通过评估患者报告的结果测量(PROMs)来告知临床护理。我们试图识别和描述经过验证的PROM,以评估OUD患者的恢复情况,重点关注PROM的特征、恢复领域和门诊实施的实用主义。方法:采用《基于共识的健康测量仪器选择标准》(COSMIN)指南进行预注册(PROSPERO: CRD42023394770)系统评价。确认的prom评估了17个恢复域中的至少一个并且包含少于50个项目。该审查描述了PROM的特征,包括项目数量、子量表、回答选项和完成时间。从患者角度评估内容效度。评估的恢复领域分为17个领域,包括药物相关、心理健康和生活质量。评估是否存在临床相关的评分变化。采用分层聚类方法描述各恢复域间的共现模式。结果:共纳入122篇研究,鉴定出90个独特的PROMs。三份prom(3%)在内容效度上获得“中等”等级。PROMs评估了4个恢复领域的中位数[四分位数间距(IQR) = 1-7],其中与药物相关的结果最常见(51%),其次是心理健康(49%)、人际关系(41%)和身体健康(36%)。19份prom(21%)包含少于10个项目,这使得它们在临床使用中非常实用。14个prom(16%)评估了8个或更多的恢复域,并被归类为综合。两个(2%)综合PROMs是根据有药物使用生活经验的个人的输入开发的,提供了以患者为中心的观点。5个prom(6%)定义了临床相关评分变化。结论:有许多患者报告的结果测量(PROMs)评估不同的,通常定义广泛的恢复领域,可用于以恢复为重点的阿片类药物使用障碍的测量为基础的护理;然而,很少有prom足够简短,可以用于临床,几乎所有prom都缺乏临床相关的评分变化,可以帮助制定治疗决策,而且很少有prom是根据有生活经验的人的意见开发的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Systematic review of patient-reported outcome measures for opioid use disorder recovery.

Background and aims: Recovery-focused measurement-based care of opioid use disorder (OUD) could inform clinical care by assessing patient-reported outcome measures (PROMs). We sought to identify and describe validated PROMs which assess recovery among patients with OUD, focusing on PROM characteristics, recovery domains and pragmatism for implementation in outpatient settings.

Methods: A preregistered (PROSPERO: CRD42023394770) systematic review was conducted using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. Validated PROMs that assessed at least one of 17 recovery domains and contained fewer than 50 items were identified. The review described PROM characteristics, including the number of items, subscales, response options and time to complete. Content validity was assessed from the patient perspective. Recovery domains assessed were categorized into 17 domains, including substance-related, psychological health and quality of life. The presence of clinically relevant score changes was assessed. Hierarchical clustering was performed to describe co-occurrence patterns among recovery domains.

Results: A total of 122 studies were included, identifying 90 unique PROMs. Three PROMs (3%) received a 'moderate' grade on content validity. PROMs assessed a median of 4 recovery domains [inter-quartile range (IQR) = 1-7], with substance-related outcomes being most common (51%), followed by psychological health (49%), relationships (41%) and physical health (36%). Nineteen PROMs (21%) contained fewer than 10 items, making them highly pragmatic for clinical use. Fourteen PROMs (16%) assessed 8 or more recovery domains and were categorized as comprehensive. Two (2%) comprehensive PROMs were developed with input from individuals with lived experience of substance use, providing a patient-centered perspective. Five PROMs (6%) defined clinically relevant score changes.

Conclusions: There are many patient-reported outcome measures (PROMs) which assess diverse and often broadly defined recovery domains that can be used in recovery-focused measurement-based care of opioid use disorder; however, few PROMs are brief enough to be pragmatic for clinical use, nearly all lack clinically relevant score changes that could help inform treatment decisions, and few were developed with input from people with lived experience.

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来源期刊
Addiction
Addiction 医学-精神病学
CiteScore
10.80
自引率
6.70%
发文量
319
审稿时长
3 months
期刊介绍: Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.
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