Patients'satisfaction and experience in treatment with opioid substitution therapy in Spain. The PREDEPO study

Adicciones. 2023 Dec 1;35(4):433-444. doi: 10.20882/adicciones.1684.
[Article in English, Spanish]

Abstract

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.

El objetivo es comparar la satisfacción, experiencia, objetivos y opinión de los pacientes con trastorno por consumo de opioides (TCO) en base a su tratamiento sustitutivo de opioides (TSO) actual (metadona o buprenorfina/naloxona (B/N)). El estudio PREDEPO es un estudio observacional, transversal, multicéntrico desarrollado en España que incluyó pacientes adultos, diagnosticados de TCO y en TSO, quienes contestaron una encuesta sobre su tratamiento actual. Se incluyeron 98 pacientes (B/N:50%, metadona:50%): edad media de 47 ± 8 años y el 80% varones. A nivel de la satisfacción con su tratamiento, los resultados fueron similares entre grupos. El factor “muy/bastante satisfactorio” que se reportó con mayor frecuencia fue “poder repartir las dosis en varios momentos del día” (44% B/N vs. 63% metadona; p = ,122). Se encontraron diferencias significativas en “tener que recoger la medicación diariamente” donde una menor proporción en el grupo B/N contestaron “muy/bastante molesto” versus el grupo metadona (19% vs. 52%, p = ,032). Los objetivos reportados por la mayoría de los pacientes fueron similares entre grupos (“no sentir más síndrome de abstinencia”, “disminuir o dejar definitivamente mi consumo de drogas”, “mejorar mi estado de salud” y “dejar de pensar en consumir todos los días”) excepto en “no tener más problemas de dinero” (72% B/N vs. 92% metadona; p = ,012). Estos resultados evidencian que existen expectativas no cubiertas con los TSO actuales y la necesidad de nuevos tratamientos que disminuyan la carga de la enfermedad, eviten la necesidad de una dosificación diaria y reduzcan el estigma, mejorando así el manejo del paciente, su adherencia y calidad de vida.

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use
  • Buprenorphine* / adverse effects
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Methadone
  • Middle Aged
  • Opiate Substitution Treatment / methods
  • Opioid-Related Disorders* / drug therapy
  • Patient Satisfaction
  • Quality of Life
  • Spain

Substances

  • Buprenorphine
  • Methadone
  • Analgesics, Opioid