Satisfacción y experiencia de pacientes en tratamiento con sustitutivos opioides en EspañaEstudio PREDEPO

  1. Francisco Pascual Pastor 1
  2. Álvaro Muñoz 2
  3. Rodrigo Oraa 3
  4. Gerardo Flórez 4
  5. Pilar Notario 5
  6. Pedro Seijo 6
  7. Begoña Gonzalvo 7
  8. Carla Assaf 8
  9. Manuel Gómez 2
  10. Miguel Ángel Casado 2
  1. 1 Generalitat Valenciana. Unidad de Conductas Adictivas – Departament de Salut d’Alcoi, Alcoi, España.
  2. 2 Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, España
  3. 3 Red de Salud Mental, IIS Biocruces Bizkaia. CSM Ajuriaguerra Adicciones. RSMB, Bizkaia, España
  4. 4 Unidad de Conductas Adictivas de Ourense, Ourense, España
  5. 5 Centro de Atención a las Adicciones de Latina, Madrid, España.
  6. 6 Diputación de Cádiz. Centro de Tratamiento Ambulatorio de Adicciones de Villamartín, Cádiz, España.
  7. 7 Red Adicciones, Institut Assistència Sanitària. Departament de Salut Centro de Atención y Seguimiento a las Drogodependencias, Girona, España.
  8. 8 Camurus SL, Madrid, España
Montrer des affiliations +
Revue:
Adicciones: Revista de socidrogalcohol

ISSN: 0214-4840

Année de publication: 2023

Volumen: 35

Número: 4

Pages: 433-444

Type: Article

DIALNET GOOGLE SCHOLAR lock_openAccès ouvert editor

D'autres publications dans: Adicciones: Revista de socidrogalcohol

Résumé

The aim of this study was to compare patients’ satisfaction, experience, objectives, and opinion based on their current opioid substitution therapy (OST) (buprenorphine/naloxone (B/N) or methadone). The PREDEPO study is an observational, cross-sectional, multicentric study performed in Spain. Adult patients diagnosed with opioid use disorder (OUD) receiving OST were included. They were asked to fill in a questionnaire regarding their current OST. A total of 98 patients were enrolled (B/N: 50%, methadone: 50%). Mean age was 47 ± 8 years old and 80% were male. Treatment satisfaction was similar between groups. The most frequently reported factor for being “very/quite satisfied” was “being able to distribute the dose at different times throughout the day” (44% B/N vs. 63% methadone; p = .122). A significantly lower proportion of patients in the B/N group versus the methadone group reported that having to collect the medication daily was “very/quite annoying” (19% vs. 52%, p = .032). Treatment objectives reported by the majority of patients were similar between groups (“not feeling in withdrawal anymore”, “reduce/definitely stop drug use”, “improve my health”, and “stop thinking about using daily”) except for “not having money problems anymore” (73% B/N vs. 92% methadone; p = .012). These results suggest there are several unmet expectations regarding current OST. There is a need for new treatments that reduce the burden of OUD, avoid the need for daily dosing, and are less stigmatizing which in turn could improve patient management, adherence and, quality of life.

Références bibliographiques

  • Alonso-Caballero, J. y Ferrer-Fóres, M. M. (2017). Resultados reportados por los pacientes (PROs). https://fundaciongasparcasal.org/wp-content/uploads/2021/02/Monografia-4-Politica_Resultados-reportados-por-los-pacientes.pdf.
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, DC: APA.
  • Bendimerad, P., Kosim, M. y Trojak, B. (2019, octubre). Patient acceptance and acceptability of a new long-acting form of buprenorphine - AMBRE survey results. Póster presentado en la 14th International Congress of Addiction, Hepatitis and AIDS, Biarritz.
  • Calvo, F., Carbonell, X., Valero, R., Costa, J., Turró, O., Giralt, C. y Ramírez, M. (2018). Abandono precoz y retención en servicios ambulatorios de drogodependencias: Análisis transversal comparativo de factores que aumentan o disminuyen la adherencia. Atención Primaria, 50, 477–485. doi:10.1016/j.aprim.2017.06.006.
  • Canadian Agency for Drugs and Technologies in Health. (2013). Rapid response reports. Suboxone® versus methadone for the treatment of opioid dependence: A review of the clinical and cost-effectiveness. http://www.ncbi.nlm.nih.gov/books/NBK195153/.
  • Dematteis, M., Auriacombe, M., D’Agnone, O., Somaini, L., Szerman, N., Littlewood, R.,… Soyka, M. (2017). Recommendations for buprenorphine and methadone therapy in opioid use disorder: A European consensus. Expert Opinion on Pharmacotherapy, 18, 1987–1999. doi:10.1080/14656566.2017.1409722.
  • Florek, A. G., Wang, C. J. y Armstrong, A. W. (2018). Treatment preferences and treatment satisfaction among psoriasis patients: A systematic review. Archives of Dermatological Research, 310, 271–319. doi:10.1007/s00403-018-1808-x.
  • Gilman, M., Li, L., Hudson, K., Lumley, T., Myers, G., Corte, C. y Littlewood, R. (2018). Current and future options for opioid use disorder: A survey assessing real-world opinion of service users on novel therapies including depot formulations of buprenorphine. Patient Preference and Adherence, 12, 2123–2129. doi:10.2147/PPA.S180641.
  • González-Saiz, F., Lozano Rojas, Ó. M., Martín Esteban, J., Bilbao Acedos, I., Ballesta Gómez, R. y Gutiérrez Ortega, J. (2011). Psychiatric comorbidity in a sample of opiate-dependent patients treated with sublingual buprenorphine in a therapeutic community regime. Revista de Psiquiatría y Salud Mental, 4, 81–87. doi:10.1016/S2173-5050(11)70013-9.
  • Harris, J. y McElrath, K. (2012). Methadone as social control: Institutionalized stigma and the prospect of recovery. Qualitative Health Research, 22, 810–824. doi:10.1177/1049732311432718.
  • Koehl, J. L., Zimmerman, D. E. y Bridgeman, P. J. (2019). Medications for management of opioid use disorder. American Journal of Health-System Pharmacy, 76, 1097–1103. doi:10.1093/ajhp/zxz105.
  • Iftikhar, A., Allah, N., Shadiullah, K., Habibullah, K., Muhammad, A. R. y Muhammad, H. K. (2011). Predictors of patient satisfaction. Gomal Journal of Medical Sciences, 9, 183-188.
  • Mateu, G., Astasls, M. y Torrens, M. (2005). Comorbilidad psiquiátrica y trastorno por dependencia de opiáceos: Del diagnóstico al tratamiento. Adicciones, 17,111-121.
  • McHugh, R. K., Murray, H. W., Hearon, B. A., Pratt, E. M., Pollack, M. H., Safren, S. A. y Otto, M. W. (2013). Predictors of dropout from psychosocial treatment in opioid-dependent outpatients. The American Journal on Addictions, 22, 18–22. doi:10.1111/j.1521-0391.2013.00317.x.
  • Neale, J., Tompkins, C.N.E., McDonald, R. y Strang, J. (2018). Patient views of opioid pharmacotherapy biodelivery systems: Qualitative study to assist treatment decision making. Experimental and Clinical Psychopharmacology, 26, 570–581. doi:10.1037/pha0000217.
  • Observatorio Europeo de las Drogas y las Toxicomanías. (2020). Informe Europeo sobre drogas 2020: Cuestiones clave. Luxemburgo: Oficina de publicaciones de la Unión Europea. https://www.emcdda.europa.eu/system/files/publications/6343/20174796_TD0117699ESN_PDF.pdf.
  • Observatorio Europeo de las Drogas y las Toxicomanías. (2019). Informe sobre drogas en España 2019. Madrid: Delegación del Gobierno para el Plan Nacional sobre Drogas. https://www.emcdda.europa.eu/system/files/publications/11353/20190725_InformeDrogasEspana2019_EMCDDA_DGPNSD.pdf.
  • Observatorio Vasco de Drogodependencias. (2004). Perfil del Drogodependiente que no responde a los programas de mantenimiento con metadona. País Vasco: GABIA. https://www.osakidetza.euskadi.eus/ataria/.
  • Pérez de Los Cobos, J., Alcaraz, S., Siñol, N., González-Saiz, F., Vergara-Moragues, E., Trujols, J. y Buprenorphine Naloxone Survey Group. (2020). Towards a common metric for assessing heroin-dependent patient satisfaction with medications: Testing methadone and buprenorphine-naloxone. Drug and Alcohol Dependence, 212, 108010. doi:10.1016/j.drugalcdep.2020.108010.
  • Rolland, B., Trojak, B., Nourredine, M., Bachellier, J., Chappuy, M., Bendimerad, P.,… Brousse, G. (2021). Determinants of interest in extended-released buprenorphine: A survey among 366 French patients treated with buprenorphine or methadone. Drug and Alcohol Dependence, 220, 108492. doi:10.1016/j.drugalcdep.2020.108492.
  • Roncero, C., Barral, C., Rodríguez-Cintas, L., Pérez-Pazos, J., Martínez-Luna, N., Casas, M.,… Grau-López, L. (2016). Psychiatric comorbidities in opioid-dependent patients undergoing a replacement therapy programme in Spain: The PROTEUS study. Psychiatry Research, 243, 174–181. doi:10.1016/j.psychres.2016.06.024.
  • Roncero, C., Domínguez-Hernández, R., Díaz, T., Fernández, J. M., Forcada, R., Martínez, J. M.,… Oyagüez, I. (2015). Management of opioid-dependent patients: Comparison of the cost associated with use of buprenorphine/naloxone or methadone, and their interactions with concomitant treatments for infectious or psychiatric comorbidities. Adicciones, 27, 179–189.
  • Roncero, C., Fuster, D., Palma-Álvarez, R. F., Rodríguez-Cintas, L., Martínez-Luna, N. y Álvarez, F. J. (2017). HIV And HCV infection among opiate-dependent patients and methadone doses: The PROTEUS study. AIDS Care, 29, 1551–1556. doi:10.1080/09540121.2017.1313384.
  • Salazar, A., Moreno, S., De Sola, H., Moral-Muñoz, J. A., Dueñas, M. y Failde, I. (2020). The evolution of opioid-related mortality and potential years of life lost in Spain from 2008 to 2017: Differences between Spain and the United States. Current Medical Research and Opinion, 36, 285–291. doi:10.1080/03007995.2019.168425.
  • Samuel, D. B., LaPaglia, D. M., Maccarelli, L. M., Moore, B. A. y Ball, S. A. (2011). Personality disorders and retention in a therapeutic community for substance dependence. The American Journal on Addictions, 20, 555–562. doi:10.1111/j.1521-0391.2011.00174.x.
  • Sordo, L., Barrio, G., Bravo, M. J., Indave, B. I., Degenhardt, L., Wiessing, L.,… Pastor-Barriuso, R. (2017). Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies. BMJ, 357, 1550. doi:10.1136/bmj.j1550.
  • Socidrogalcohol. (2018). Guía de adicciones para especialistas en formación. Valencia: Socidrogalcohol. https://socidrogalcohol.org/wp-content/Pdf/publicaciones/manuales-guias/guia-adicciones-para-especialistas.pdf.
  • Strang, J., Reed, K., Bogdanowicz, K., Bell, J., van der Waal, R., Keen, J.,… Knight, A. (2017). Randomised comparison of a novel buprenorphine oral lyophilisate versus existing buprenorphine sublingual tablets in opioid-dependent patients: A first-in-patient phase II randomised open label safety study. European Addiction Research, 23, 61–70. doi:10.1159/000456612.
  • Treloar, C. y Valentine, K. (2013). Examining structural violence in opioid pharmacotherapy treatment in Australia: Sweating the “small stuff” in a liberal paradise. The International Journal on Drug Policy, 24, 11–13. doi:10.1016/j.drugpo.2013.04.010.
  • Volkow, N. D., Frieden, T. R., Hyde, P. S. y Cha, S. S. (2014). Medication-assisted therapies-tackling the opioid-overdose epidemic. The New England Journal of Medicine, 370, 2063–2066. doi:10.1056/NEJMp1402780.
  • Vorspan, F., Hjelmström, P., Simon, N., Benyamina, A., Dervaux, A., Brousse, G.,… Rolland, B. (2019). What place for prolonged-release buprenorphine depot-formulation Buvidal® in the treatment arsenal of opioid dependence? Insights from the French experience on buprenorphine. Expert Opinion on Drug Delivery, 16, 907–914. doi:10.1080/17425247.2019.1649252.
  • World Health Organization. (2018). Information sheet on opioid overdose. Ginebra: World Health Organization. https://www.who.int/substance_abuse/information-sheet/en/.
La source de données: Dialnet