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
in English
| LILACS
| ID: biblio-1285540
Responsible library:
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.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Health and Well-Being
/
SDG3 -Target 3.5 Prevention and treatment of consumption of psychoactive substances
Health problem:
Target 3.5: Prevention and treatment of consumption of psychoactive substances
/
Opioid Abuse
Database:
LILACS
Main subject:
Behavior, Addictive
/
Opioid-Related Disorders
Type of study:
Practice guideline
/
Prognostic study
/
Qualitative research
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
North America
Language:
English
Journal:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Journal subject:
Psychiatry
Year:
2021
Document type:
Article
Affiliation country:
Canada
Institution/Affiliation country:
Halton Healthcare/CA
/
Laurentian University/CA
/
McMaster University/CA