دورية أكاديمية
أعرض في EDS

Effectiveness of incentivised adherence and abstinence monitoring in buprenorphine maintenance: a pragmatic, randomised controlled trial.

التفاصيل البيبلوغرافية
العنوان: Effectiveness of incentivised adherence and abstinence monitoring in buprenorphine maintenance: a pragmatic, randomised controlled trial.
المؤلفون: Elarabi HF; National Rehabilitation Centre, Abu Dhabi, United Arab Emirates.; Addictions Department, Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK., Shawky M; National Rehabilitation Centre, Abu Dhabi, United Arab Emirates.; Department of Neuropsychiatry, Faculty of Medicine, Assuit University, Egypt., Mustafa N; National Rehabilitation Centre, Abu Dhabi, United Arab Emirates., Radwan D; National Rehabilitation Centre, Abu Dhabi, United Arab Emirates.; Faculty of Medicine, Institute of Psychiatry, Ain Shams University, Egypt., Elarasheed A; National Rehabilitation Centre, Abu Dhabi, United Arab Emirates., Yousif Ali A; National Rehabilitation Centre, Abu Dhabi, United Arab Emirates., Osman M; World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt., Kashmar A; National Rehabilitation Centre, Abu Dhabi, United Arab Emirates., Al Kathiri H; National Rehabilitation Centre, Abu Dhabi, United Arab Emirates., Gawad T; National Rehabilitation Centre, Abu Dhabi, United Arab Emirates.; Faculty of Medicine, Cairo University, Egypt., Kodera A; National Rehabilitation Centre, Abu Dhabi, United Arab Emirates., Al Jneibi M; National Rehabilitation Centre, Abu Dhabi, United Arab Emirates., Adem A; Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Khalifa University, P.O.Box 127788, Abu Dhabi, United Arab, Emirates., Lee AJ; Medical Statistics Team, University of Aberdeen, UK., Marsden J; Addictions Department, Division of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
المصدر: Addiction (Abingdon, England) [Addiction] 2021 Sep; Vol. 116 (9), pp. 2398-2408. Date of Electronic Publication: 2021 Jan 28.
نوع المنشور: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9304118 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1360-0443 (Electronic) Linking ISSN: 09652140 NLM ISO Abbreviation: Addiction Subsets: MEDLINE
أسماء مطبوعة: Publication: Oxford : Wiley-Blackwell
Original Publication: Abingdon, Oxfordshire, UK : Carfax Pub. Co., c1993-
مواضيع طبية MeSH: Buprenorphine*/therapeutic use , Opioid-Related Disorders*/drug therapy, Adult ; Analgesics, Opioid/therapeutic use ; Humans ; Medication Adherence ; Narcotic Antagonists/therapeutic use ; Treatment Outcome
مستخلص: Background and Aim: Buprenorphine (BUP) maintenance treatment for opioid use disorder (OUD) begins with supervised daily dosing. We estimated the clinical effectiveness of a novel incentivised medication adherence and abstinence monitoring protocol in BUP maintenance to enable contingent access to increasing take-home medication supplies.
Design: Two-arm, single-centre, pragmatic, randomised controlled trial of outpatient BUP maintenance, with during-treatment follow-ups at 4 weeks, 8 weeks, 12 weeks and 16 weeks.
Setting: Inpatient and outpatient addictions treatment centre in the United Arab Emirates.
Participants: Adults with OUD, voluntarily seeking treatment.
Interventions: The experimental condition was 16 weeks BUP maintenance with incentivised adherence and abstinence monitoring (I-AAM) giving contingent access to 7-day, then 14-day, then 21-day and 28-day medication supply. The control, treatment-as-usual (TAU) was 16 weeks BUP maintenance, with contingent access to 7-day then 14-day supply.
Measurements: The primary outcome was number of negative urine drug screens (UDS) for opioids, with non-attendance or otherwise missed UDS, imputed as positive for opioids. The secondary outcome was retention in treatment (continuous enrolment to the 16-week endpoint).
Findings: Of 182 patients screened, 171 were enrolled and 141 were randomly assigned to I-AAM (70 [49.6%]) and to TAU (71 [50.4%]. Follow-up rates at 4 weeks, 8 weeks, 12 weeks and 16 weeks were 91.4%, 85.7%, 71.0%, 60.0% respectively in I-AAM and 84.5%, 83.1%, 69.0%, 56.3% in TAU. By intention-to-treat, the absolute difference in percentage negative UDS for opioids was 76.7% (SD = 25.0%) in I-AAM versus 63.5% (SD = 34.7%) in TAU (mean difference = 13.3%; 95% CI = 3.2%-23.3%; Cohen's d = 0.44; 95% CI = 0.10-0.87). In I-AAM, 40 participants (57.1%) were retained versus 33 (46.4%) in TAU (odds ratio = 1.54; 95% CI = 0.79-2.98).
Conclusions: Buprenorphine maintenance with incentivised therapeutic drug monitoring to enable contingent access to increasing take-home medication supplies increased abstinence from opioids compared with buprenorphine maintenance treatment-as-usual, but it did not appear to increase treatment retention.
(© 2021 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)
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معلومات مُعتمدة: 001 International WHO_ World Health Organization
فهرسة مساهمة: Keywords: abstinence; adherence; buprenorphine; effectiveness; opioid use disorder; therapeutic drug monitoring
المشرفين على المادة: 0 (Analgesics, Opioid)
0 (Narcotic Antagonists)
40D3SCR4GZ (Buprenorphine)
تواريخ الأحداث: Date Created: 20210106 Date Completed: 20210930 Latest Revision: 20210930
رمز التحديث: 20240628
DOI: 10.1111/add.15394
PMID: 33404141
قاعدة البيانات: MEDLINE
الوصف
تدمد:1360-0443
DOI:10.1111/add.15394