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
Artigo
em Inglês
| LILACS
| ID: biblio-1285540
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.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Comportamento Aditivo
/
Transtornos Relacionados ao Uso de Opioides
Tipo de estudo:
Guia de Prática Clínica
/
Estudo prognóstico
/
Pesquisa qualitativa
/
Fatores de risco
Limite:
Adulto
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
América do Norte
Idioma:
Inglês
Revista:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Assunto da revista:
Psiquiatria
Ano de publicação:
2021
Tipo de documento:
Artigo
País de afiliação:
Canadá
Instituição/País de afiliação:
Halton Healthcare/CA
/
Laurentian University/CA
/
McMaster University/CA
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