The future of precision medicine in opioid use disorder: inclusion of patient-important outcomes in clinical trials
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
; 43(2): 138-146, Mar.-Apr. 2021. tab, graf
Article
en En
| LILACS
| ID: biblio-1285540
Biblioteca responsable:
BR1.1
ABSTRACT
Opioid use has reached an epidemic proportion in Canada and the United States that is mostly attributed to excess availability of prescribed opioids for pain. This excess in opioid use led to an increase in the prevalence of opioid use disorder (OUD) requiring treatment. The most common treatment recommendations include medication-assisted treatment (MAT) combined with psychosocial interventions. Clinical trials investigating the effectiveness of MAT, however, have a limited focus on effectiveness measures that overlook patient-important outcomes. Despite MAT, patients with OUD continue to suffer negative consequences of opioid use. Patient goals and personalized medicine are overlooked in clinical trials and guidelines, thus missing an opportunity to improve prognosis of OUD by considering precision medicine in addiction trials. In this mixed-methods study, patients with OUD receiving MAT (n=2,031, mean age 39.1 years [SD 10.7], 44% female) were interviewed to identify patient goals for MAT. The most frequently reported patient-important outcomes were to stop treatment (39%) and to avoid all drugs (25%). These results are inconsistent with treatment recommendations and trial outcome measures. We discuss theses inconsistencies and make recommendations to incorporate these outcomes to achieve patient-centered and personalized treatment strategies.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
LILACS
Contexto en salud:
2_ODS3
/
8_ODS3_consumo_sustancias_psicoactivas
Problema de salud:
2_sustancias_psicoativas
/
8_opioid_abuse
Asunto principal:
Conducta Adictiva
/
Trastornos Relacionados con Opioides
Tipo de estudio:
Guideline
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Asunto de la revista:
PSIQUIATRIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Canadá