scholarly journals Evaluation of functional status among patients undergoing maintenance treatments for opioid use disorders

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Juan J. Ruíz Ruíz ◽  
◽  
José M. Martinez Delgado ◽  
Nuria García-Marchena
Keyword(s):  
Functional Status ◽  
Methadone Treatment ◽  
Social Activity ◽  
Sexual Problems ◽  
Functional Evaluation ◽  
Opioid Use ◽  
Whodas 2.0 ◽  
Maintenance Program ◽  
Methadone Group ◽  
Health Domains

Abstract Background Methadone and buprenorphine are the most prevalent types of opioid maintenance programs in Andalusia. The main objective is comparing the functional status of patients with pharmacological opioid maintenance treatments according to different socio-demographic characteristic, health and disabilities domains and sexual difficulties. Methods A total of 593 patients from the Andalusia community, 329 were undergoing methadone treatment and 264 were undergoing buprenorphine treatment. The patients were interviewed by socio-demographic and opioid-related variables, assessed by functioning, disability and health domains (WHODAS 2.0.) and for sexual problems (PRSexDQ-SALSEX). Results We found significant differences in the socio-demographic and the opioid-related variables as the onset of opioid use, being on previous maintenance programs, opioid intravenous use, the length of previous maintenance programs, polydrug use and elevated seroprevalence rates (HCV and HIV) between the methadone group and the buprenorphine group. Regarding health and disability domains there were differences in the Understanding and communication domain, Getting around domain, Participation in society domain and in the WHODAS 2.0. simple and complex score, favoring buprenorphine-treated patients. The methadone group referred elevated sexual impairments compared with the buprenorphine group. Opioid-related variables as seroprevalence rates, other previous lifetime maintenance program, the daily opioid dosage and the daily alcohol use are the most discriminative variables between both groups. Participation in society variables and sexual problems were the most important clinical variables in distinguishing the methadone group from the buprenorphine group regarding their functional status. Conclusions The methadone group showed higher prevalence in opioid dependence-related variables, elevated disabilities in participation in society activities and sexual problems compared with the buprenorphine group. This study shows the importance of carry out a functional evaluation in the healthcare follow-up, especially in those areas related with social activity and with sexual problems.

Evaluation of Functional Status Among Patients Undergoing Maintenance Treatments for Opioid use Disorders

2020 ◽  
Author(s):  
Juan Jesús Ruíz Ruíz ◽  
José María Martínez Delgado ◽  
Nuria García ◽  
Bartolomé Baena
Keyword(s):  
Sexual Dysfunction ◽  
Opioid Dependence ◽  
Functional Disability ◽  
Methadone Treatment ◽  
Sexual Problems ◽  
Opioid Use ◽  
Whodas 2.0 ◽  
Maintenance Program ◽  
Methadone Group ◽  
Buprenorphine Treatment

Abstract Objective Methadone and buprenorphine are the most prevalent types of opioid maintenance programs in Andalusia. The main objective is comparing the functional and health status of patients with pharmacological opioid maintenance treatments according to different socio-demographic characteristic, disabilities and sexual functioning difficulties. Methods A total of 593 patients from the Andalusia community, 329 were undergoing methadone treatment and 264 were undergoing buprenorphine treatment. The patients were interviewed by socio-demographic and opioid-related variables, assessed by functional disability and health variables ( WHODAS 2.0. ) and for sexual dysfunction ( PRSexDQ-SALSEX ). Results We found significant differences in the socio-demographic and the opioid-related variables as the onset of opioid use, being on previous maintenance programs, opioid intravenous use, the length of previous maintenance programs, polydrug use and elevated seroprevalence rates (HCV and HIV) between the methadone group and the buprenorphine group. There were differences in the Understanding and communication domain, Getting around domain, Participation in society domain and in the WHODAS 2.0. simple and complex score, favoring buprenorphine-treated patients. The methadone group had elevated sexual dysfunction than the buprenorphine group. Opioid-related variables as seroprevalence rates, other previous lifetime maintenance program, the daily opioid dosage and the daily alcohol use are the most discriminative variables between both groups. Participation in society variables and sexual problems were the most important clinical variables in distinguishing the methadone group from the buprenorphine group. Conclusions The methadone group showed higher prevalence in opioid dependence-related variables, elevated disabilities in participation in society activities and sexual problems compared with the buprenorphine group.

scholarly journals Can Traditional Chinese Medicine Diagnosis Be Parameterized and Standardized? A Narrative Review

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 177
Author(s):  
Luís Carlos Matos ◽  
Jorge Pereira Machado ◽  
Fernando Jorge Monteiro ◽  
Henry Johannes Greten
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Functional Status ◽  
Control Measures ◽  
Systematic Evaluation ◽  
Diagnostic Tools ◽  
Functional Evaluation ◽  
Diagnostic Systems ◽  
Mechanical Pulse ◽  
Proof Of Efficacy

The integration of Traditional Chinese Medicine (TCM) in Western health systems and research requires a rational communicable theory, scientific proof of efficacy and safety, and quality control measures. The existence of clear definitions and the diagnosis standardization are critical factors to establish the patient’s vegetative functional status accurately and, therefore, systematically apply TCM therapeutics such as the stimulation of reflex skin areas known as acupoints. This science-based conceptualization entails using validated methods, or even developing new systems able to parameterize the diagnosis and assess TCM related effects by objective measurements. Traditionally, tongue and pulse diagnosis and the functional evaluation of action points by pressure sensitivity and physical examination may be regarded as essential diagnostic tools. Parameterizing these techniques is a future key point in the objectification of TCM diagnosis, such as by electronic digital image analysis, mechanical pulse diagnostic systems, or the systematic evaluation of acupoints’ electrophysiology. This review aims to demonstrate and critically analyze some achievements and limitations in the clinical application of device-assisted TCM diagnosis systems to evaluate functional physiological patterns. Despite some limitations, tongue, pulse, and electrophysiological diagnosis devices have been reported as a useful tool while establishing a person’s functional status.

scholarly journals Exploring Factors Associated with Functional Change and Predictors of Participation Improvement—A Two Years Follow-Up on People with Depression

2021 ◽  
Vol 18 (7) ◽  
pp. 3439
Author(s):  
Wen-Chou Chi ◽  
Chia-Feng Yen ◽  
Tsan-Hon Liou ◽  
Kwang-Hwa Chang ◽  
Hua-Fang Liao ◽  
...  
Keyword(s):  
Functional Status ◽  
Social Participation ◽  
Negative Relationship ◽  
General Function ◽  
Living Situation ◽  
Persons With Disabilities ◽  
Factors Associated ◽  
Whodas 2.0 ◽  
Household Activities

The purpose of this study is to understand the functional status distribution and to explore the factors associated with changes in functional status and social participation in people with depression using two-year follow-up data. Subjects were selected from the Taiwan Databank of Persons with Disabilities (TDPD) if they had an evaluation date between July 2012 and 31 December 2017. We used data for 1138 individuals with multiple evaluation records and who were diagnosed with depression. The WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) was the primary functional status measure. Other factors selected from the TDPD included social demographic data, living situation, employment status, economic status, and educational level. The results show scores in all dimensions of the WHODAS 2.0 declined over two years, especially in the domains of cognition, household activities, social participation, and total WHODAS 2.0 score. Aging groups showed poor recovery in cognition, getting along with others, and household activities. People living in suburban areas showed poorer recovery than people living in rural and urban areas in cognition, self-care, and general function (total score of WHODAS 2.0). Employment was also strongly associated with functional recovery in household activities, social participation, and general function. The original scores for cognition and getting along with others showed a significant negative relationship with social participation improvement. Our results can be used by policy makers to provide resources and conduct investigations, and by clinicians when making rehabilitation plans.

Comparisons of Injection and Non-Injection Opioid Use among Black People in Methadone Treatment: A Pilot Study in Detroit

2021 ◽  
pp. 107182
Author(s):  
Cara A. Struble ◽  
Jamey J. Lister ◽  
Joseph Urbiel ◽  
Amesika N. Nyaku ◽  
Cynthia L. Arfken
Keyword(s):  
Pilot Study ◽  
Black People ◽  
Methadone Treatment ◽  
Opioid Use

scholarly journals A call for consensus in defining efficacy in clinical trials for opioid addiction: combined results from a systematic review and qualitative study in patients receiving pharmacological assisted therapy for opioid use disorder

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Brittany B. Dennis ◽  
Nitika Sanger ◽  
Monica Bawor ◽  
Leen Naji ◽  
Carolyn Plater ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Addiction Treatment ◽  
Treatment Effectiveness ◽  
Methadone Treatment ◽  
Population Level ◽  
Opioid Addiction ◽  
Complex Nature ◽  
Opioid Use ◽  
Structured Interviews ◽  
Patient Reported

Abstract Background Given the complex nature of opioid addiction treatment and the rising number of available opioid substitution and antagonist therapies (OSAT), there is no ‘gold standard’ measure of treatment effectiveness, and each successive trial measures a different set of outcomes which reflect success in arbitrary or opportune terms. We sought to describe the variation in current outcomes employed across clinical trials for opioid addiction, as well as determine whether a discrepancy exists between the treatment targets that patients consider important and how treatment effectiveness is measured in the literature. Methods We searched nine commonly used databases (e.g., EMBASE, MEDLINE) from inception to August 1, 2015. Outcomes used across trials were extracted and categorized according to previously established domains. To evaluate patient-reported goals of treatment, semi-structured interviews were conducted with 18 adults undergoing methadone treatment. Results We identified 60 trials eligible for inclusion. Once outcomes were categorized into eight broad domains (e.g., abstinence/substance abuse), we identified 21 specific outcomes with furthermore 53 subdomains and 118 measurements. Continued opioid use and treatment retention were the most commonly reported measures (46%, n = 28). The majority of patients agreed that abstinence from opioids was a primary goal in their treatment, although they also stressed goals under-reported in clinical trials. Conclusions There is inconsistency in the measures used to evaluate the effectiveness of OSATs. Individual and population level decision making is being guided by a standard of effect considered useful to researchers yet in direct conflict with what patients deem important. Trial registration PROSPERO, CRD42013006507.

The Effectiveness of In-Jail Methadone Maintenance

1993 ◽  
Vol 23 (1) ◽  
pp. 75-99 ◽  
Author(s):  
Stephen Magura ◽  
Andrew Rosenblum ◽  
Carla Lewis ◽  
Herman Joseph
Keyword(s):  
New York ◽  
Methadone Maintenance ◽  
Methadone Treatment ◽  
Outcome Evaluation ◽  
Community Treatment ◽  
Maintenance Program ◽  
Lower Drug ◽  
Methadone Maintenance Program ◽  
Abuse Treatment

Process and outcome evaluation results are reported for a unique in-jail methadone maintenance program in New York City with three thousand admissions annually. The main study examined inmates who were not enrolled in methadone at arrest. Eighty percent were drug injectors (usually both heroin and cocaine) who admitted committing an average of 117 property crimes and nineteen violent crimes in the six months before jail. Methadone program participants' post-release outcomes were compared with outcomes for similar addicts who received seven-day heroin detoxification in jail. Multivariate analyses indicated that program participants were more likely than controls to apply for methadone or other drug abuse treatment after release and to be in treatment at a 6.5-month follow-up. Moreover, being in treatment at follow-up was associated with lower drug use and crime, but rates of retention in community treatment after release were modest. KEEP participants have more chronic and severe social and personal deficits than other addicts applying for treatment. The in-jail program was most effective in maintaining post-release continuity of methadone treatment for inmates already enrolled in methadone at arrest. The process evaluation yielded several recommendations to help overcome client-centered, administrative, and systemic obstacles to improved outcomes for this difficult-to-treat population of criminally-involved addicts.

scholarly journals Cognitive profiles in persons with opioid use disorder enrolled in methadone treatment

2020 ◽  
pp. 1-7
Author(s):  
Victoria Sanborn ◽  
John Gunstad ◽  
Roman Shrestha ◽  
Colleen B. Mistler ◽  
Michael M. Copenhaver
Keyword(s):  
Methadone Treatment ◽  
Opioid Use Disorder ◽  
Cognitive Profiles ◽  
Opioid Use

scholarly journals Using Microdosing to Induct Patients Into a Long-Acting Injectable Buprenorphine Depot Medication in Low Threshold Community Settings: A Case Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Joseph Tay Wee Teck ◽  
Alexander Baldacchino ◽  
Lauren Gibson ◽  
Con Lafferty
Keyword(s):  
Methadone Treatment ◽  
Opioid Use Disorder ◽  
High Dose ◽  
Opioid Use ◽  
Access To Treatment ◽  
Medication Assisted Treatment ◽  
Low Threshold ◽  
Healthcare Innovation ◽  
Long Acting

Healthcare innovation has never been more important as it is now when the world is facing up to the unprecedented challenges brought by the COVID-19 pandemic. Within addictions services in Scotland, the priority has been to tackle our rising drug related death rate by maintaining and improving access to treatment while protecting frontline workers and managing operational challenges as a result of the pandemic. We present here a case study of five patients with opioid use disorder whose treatment represents a confluence of three important Medication Assisted Treatment (MAT) service innovations. The first was a low threshold drop in and outreach MAT service to rapidly and safely initiate opiate replacement therapy (ORT). The second was the provision of a microdosing regimen to enable same day induction to oral buprenorphine while minimizing the risk of precipitated opioid withdrawals and/or treatment disengagement. The third was rapid transitioning to an injectable long-acting buprenorphine depot which reduced unnecessary face to face patient contact and treatment non-adherence. This case study of five patients highlights the valuable role that buprenorphine microdosing can play in making induction to long-acting buprenorphine depot feasible to a broader range of patients, including those on a high dose methadone treatment regime.

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