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Evaluation of medication-assisted treatment of opioid dependence—The physicians’ perspective

Overview of attention for article published in Drug & Alcohol Dependence, May 2016
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Title
Evaluation of medication-assisted treatment of opioid dependence—The physicians’ perspective
Published in
Drug & Alcohol Dependence, May 2016
DOI 10.1016/j.drugalcdep.2016.04.039
Pubmed ID
Authors

Marc Vogel, Carlos Nordt, Kenneth M. Dürsteler, Undine E. Lang, Erich Seifritz, Michael Krausz, Marcus Herdener

Abstract

There is controversy about which outcome parameters should be employed to assess substance use treatment. Subjective measures of medication-assisted treatment (MAT) of opioid dependence are increasingly important. However, while patients' perspectives have been examined, the caregivers' views remain largely unknown. Here, we explore how physicians evaluate MAT, and which predictors are most relevant. We conducted a retrospective cohort study of all MAT episodes with oral opioid agonists in the canton of Zurich between 1998 and 2013 using a case register. Termination forms of the register include a physician-completed assessment on the course of the treatment episode. Mixed model analysis was applied to determine relevant predictors. The analysis was based on 17,234 episodes from 7432 patients. Mean global assessment of the course of MAT was 'moderate'. The most important predictors for treatment evaluation by physicians were treatment break off as reason for termination (p<0.0001), psychological improvement throughout treatment (p<0.0001), wish for abstinence from the substitute (p<0.0001), social integration index at termination (p<0.0001), and social (p<0.0001) as well as medical (p<0.0001) improvement. The negative association of treatment break off with MAT assessment was more pronounced in semi-rural than urban areas (p<0.0001). Predictors relating to the well-being and functioning of the patient as well as the reasons underlying treatment termination appear to be more important for the treating physician's evaluation of medication-assisted treatment episodes than on-going substance use. Coming off the opioid medication plays a central role, independent of ongoing illicit substance use.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 71 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 71 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 12 17%
Student > Master 12 17%
Student > Ph. D. Student 9 13%
Student > Doctoral Student 7 10%
Student > Bachelor 4 6%
Other 8 11%
Unknown 19 27%
Readers by discipline Count As %
Psychology 12 17%
Medicine and Dentistry 11 15%
Social Sciences 8 11%
Nursing and Health Professions 6 8%
Neuroscience 3 4%
Other 10 14%
Unknown 21 30%