Treatment with injectable hydromorphone: Comparing retention in double blind and open label treatment periods.
J Subst Abuse Treat
; 101: 50-54, 2019 06.
Article
em En
| MEDLINE
| ID: mdl-31174713
ABSTRACT
BACKGROUND:
In a double-blind, non-inferiority randomized controlled trial injectable hydromorphone, a licensed short acting opioid analgesic, was shown to be as effective as diacetylmorphine for the treatment of severe opioid use disorder. An appropriate question is whether hydromorphone offered open-label can attract and retain patients.METHODS:
This is a retrospective study, using daily prescription data from the Crosstown Clinic in Vancouver, Canada. Treatment retention among participants who had the opportunity to receive open-label injectable hydromorphone for at least 90 consecutive days (nâ¯=â¯108) before having the choice of receiving open-label diacetylmorphine, was compared to their retention outcomes with double-blind injectable opioid agonist treatment (iOAT). McNemar tests analyzed differences in proportions; a conditional logistic model estimated exact odds ratios; Pairwise t-tests analyzed differences in total number of treatment days; and Kaplan-Meier curves and clustered log-rank tests compared time to first 30 continuous days without injectable treatment.RESULTS:
A total of 74 participants (68.5%) were retained in both open-label hydromorphone and double-blind iOAT. Open-label hydromorphone was not significantly associated with lower retention (ORâ¯=â¯0.5; 95% CI 0.2, 1.1; pâ¯=â¯.10). Participants attended a mean of 84.4 (SDâ¯=â¯15.8) days of iOAT in the trial and 80.5 (SDâ¯=â¯22.0) days in open-label hydromorphone (mean difference of -3.9; 95% CIâ¯=â¯-8.9, 1.1). Kaplan-Meier curves and log-rank tests were not statistically significant.CONCLUSION:
As treatment with injectable hydromorphone expands across Canada, our study contributes in a unique manner by providing evidence that the high retention rates observed during the clinical trial were maintained when participants started open-label hydromorphone.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Aceitação pelo Paciente de Cuidados de Saúde
/
Heroína
/
Hidromorfona
/
Analgésicos Opioides
/
Transtornos Relacionados ao Uso de Opioides
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article