目的:临床试验支持对阿片类药物使用障碍(OUD)患者进行可注射阿片类激动剂治疗(iOAT),其他药物管理方法不适合。然而,尽管大量研究表明以人为本的护理可以提高参与度,OUD患者的保留率和健康结果,结构要求(例如药物政策)通常规定了iOAT必须如何交付,无论客户偏好如何。这项研究旨在量化客户的iOAT交付偏好,以提高客户参与度和保留率。
方法:横断面偏好启发调查。
方法:大温哥华,不列颠哥伦比亚省,加拿大。
方法:124当前和以前的iOAT客户端。
方法:参与者完成了人口统计问卷包和面试官主导的偏好启发调查(案例2最佳-最差缩放任务)。潜在类别分析用于识别不同的偏好组,并探索偏好组之间的人口统计学差异。
结果:大多数参与者(n=100;81%)是当前的iOAT客户。潜在类别分析确定了两组不同的客户偏好:(1)自主决策者(n=73;59%)和(2)共享决策者(n=51;41%)。这些组对如何选择药物类型和剂量有不同的偏好。两组都优先获得带回家的药物(即携带),能够设定自己的时间表,在他们喜欢的空间接收iOAT,并在iOAT诊所提供其他服务。与共同决策者相比,更少的自主决策者被确定为顺式男性/男性,并报告了灵活的偏好。
结论:在温哥华调查的可注射阿片类药物激动剂治疗(iOAT)客户,加拿大,在选择OAT药物类型方面,他们似乎更喜欢更大的自主权,剂量和治疗时间表。
OBJECTIVE: Clinical trials support injectable opioid agonist treatment (iOAT) for individuals with opioid use disorder (OUD) for whom other pharmacological management approaches are not well-suited. However, despite substantial research indicating that person-centered care improves engagement, retention and health outcomes for individuals with OUD, structural requirements (e.g. drug policies) often dictate how iOAT must be delivered, regardless of client preferences. This study aimed to quantify clients\' iOAT delivery preferences to improve client engagement and retention.
METHODS: Cross-sectional preference elicitation survey.
METHODS: Metro Vancouver, British Columbia, Canada.
METHODS: 124 current and former iOAT clients.
METHODS: Participants completed a demographic questionnaire package and an interviewer-led preference elicitation survey (case 2 best-worst scaling task). Latent class analysis was used to identify distinct preference groups and explore demographic differences between preference groups.
RESULTS: Most participants (n = 100; 81%) were current iOAT clients. Latent class analysis identified two distinct groups of client preferences: (1) autonomous decision-makers (n = 73; 59%) and (2) shared decision-makers (n = 51; 41%). These groups had different preferences for how medication type and dosage were selected. Both groups prioritized access to take-home medication (i.e. carries), the ability to set their own schedule, receiving iOAT in a space they like and having other services available at iOAT clinics. Compared with shared decision-makers, fewer autonomous decision-makers identified as a cis-male/man and reported flexible preferences.
CONCLUSIONS: Injectable opioid agonist treatment (iOAT) clients surveyed in Vancouver, Canada, appear to prefer greater autonomy than they currently have in choosing OAT medication type, dosage and treatment schedule.