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Title: | Effectiveness of buprenorphine-based treatment compared to methadone in adult opioid maintenance therapy |
Authors: | Shannon, Jason |
Keywords: | Buprenorphine -- Therapeutic use Methadone maintenance Opioids |
Issue Date: | 2013 |
Abstract: | Opioid dependence is a health and social crisis associated with increased morbidity and mortality. When a person becomes dependent on opioids such as heroin, it is not only the individual who suffers from the repercussions. The adverse effects can have a negative impact on the general society, healthcare and economical well-being. In Malta and other European Countries, both methadone and buprenorphine are recommended drugs for the maintenance treatment of opioid dependence. However, despite the beneficial effects that buprenorphine is acclaimed for, this medication has failed to overtake methadone in managing opioid addiction. The aim of this critical appraisal was to investigate whether buprenorphine-based treatment is as effective as methadone in maintenance therapy. The following question was put forward: In adults with an opioid dependence, is buprenorphine-based treatment as effective as methadone in maintenance therapy? Adults with an opioid dependence were the population of interest, whilst buprenorphine (Subutex®) and buprenorphine-naloxone (Suboxone®) were the main interventions of choice. Methadone was the comparison intervention, and the outcome was measured by retention in treatment and abstinence from illicit substances. A broad search of the literature was conducted by using reputable databases through The University of Malta and The University of Glamorgan. Studies were retrieved by the identification of keywords that were relevant to the PICO framework. The resultant studies were scrutinised against specific inclusion and exclusion criteria, such as research design and year of publication. Eleven studies were finally chosen and were critically appraised using Russo's approach and the Critical Appraisal Skills Programme tool. The findings highlight the usefulness of buprenorphine-based treatment in the management of opioid dependence. The outcome reveals that although methadone remains an essential maintenance therapy option, buprenorphine-based treatment increases access to care and provides safer, more appropriate treatment than methadone for some patients. To highlight the evidence, this appraisal makes several recommendations for research, education, practice, management and policy change. This is followed by the strategies for finding's distribution. Education to nurses and to those with an opioid dependence was deemed to be the most important recommendations. |
Description: | B.SC.(HONS)MENTAL HEALTH NURSING |
URI: | https://www.um.edu.mt/library/oar//handle/123456789/9239 |
Appears in Collections: | Dissertations - FacHSc - 2013 Dissertations - FacHScMH - 2013 |
Files in This Item:
File | Description | Size | Format | |
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13BSMH004.pdf Restricted Access | 3.1 MB | Adobe PDF | View/Open Request a copy |
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