青年精神病患者对以大麻为重点的减低危害干预措施的偏好:一项横断面研究

Stephanie Coronado-Montoya, Amal Abdel-Baki, David Crockford, José Côté, Simon Dubreucq, Alina Dyachenko, Benedikt Fischer, Tania Lecomte, Sophie L’Heureux, Clairélaine Ouellet-Plamondon, Marc-André Roy, Philip Tibbo, Marie Villeneuve, Didier Jutras-Aswad
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This study aimed to determine preferences of young adults with EP who use cannabis for cannabis-focused harm reduction interventions.MethodsEighty-nine young adults across Canada with EP interested in reducing cannabis-related harms were recruited. An online questionnaire combining conventional survey methodology and two unique discrete choice experiments (DCEs) was administered. One DCE focused on attributes of core harm reduction interventions (DCE 1) and the second on attributes of boosters (DCE 2). We analysed these using mixed ranked-ordered logistic regression models. Preference questions using conventional survey methodology were analysed using summary statistics.ResultsPreferred characteristics for cannabis-focused harm reduction interventions (DCE 1) were: shorter sessions (60 min vs. 10 min, odds ratio (OR): 0.72; P < 0.001); less frequent sessions (daily vs. monthly, OR: 0.68; P < 0.001); shorter interventions (3 months vs. 1 month, OR: 0.80; P < 0.01); technology-based interventions (vs. in-person, OR: 1.17; P < 0.05). Preferences for post-intervention boosters (DCE 2) included opting into boosters (vs. opting out, OR: 3.53; P < 0.001) and having shorter boosters (3 months vs. 1 month, OR: 0.79; P < 0.01). 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引用次数: 0

摘要

目标吸食大麻在早期精神病(EP)患者中很常见,并且与治疗效果较差有关。针对这一人群使用大麻行为的针对性干预措施很少,大多数侧重于戒断,没有一种侧重于减少危害。许多 EP 患者不会因使用大麻而寻求现有治疗方案的治疗。了解他们对以减少大麻危害为重点的干预措施的偏好可能是改善治疗效果的关键。本研究旨在确定使用大麻的 EP 患者对以大麻为重点的减害干预措施的偏好。方法在加拿大各地招募了 89 名对减少大麻相关危害感兴趣的 EP 患者。调查问卷结合了传统调查方法和两个独特的离散选择实验(DCE)。一个离散选择实验侧重于核心减害干预措施的属性(离散选择实验 1),第二个离散选择实验侧重于促进措施的属性(离散选择实验 2)。我们使用混合排序逻辑回归模型对其进行了分析。使用传统调查方法对偏好问题进行了汇总统计分析。结果以大麻为重点的减害干预措施(DCE 1)的首选特征是:疗程更短(60 分钟对 10 分钟,几率比(OR):0.72;P <;0.001);较少的疗程次数(每天与每月相比,OR:0.68;P <;0.001);较短的干预时间(3 个月与 1 个月相比,OR:0.80;P <;0.01);基于技术的干预(与面对面相比,OR:1.17;P <;0.05)。对干预后强化治疗(DCE 2)的偏好包括选择强化治疗(与选择不强化治疗相比,OR:3.53;P <;0.001)和缩短强化治疗时间(3 个月与 1 个月相比,OR:0.79;P <;0.01)。近一半的参与者倾向于将减少使用大麻作为主要干预目标(与以危害较小的方式使用大麻或避免危险情况相比)。结论需要进一步研究基于技术的减少大麻危害干预措施是否能将这些倾向转化为 EP 患者更多的参与和更好的治疗效果。
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Preferences of Young Adults With Psychosis for Cannabis-Focused Harm Reduction Interventions: A Cross-Sectional Study: Préférences des jeunes adultes souffrant de psychose pour les interventions de réduction des méfaits axées sur le cannabis : une étude transversale
ObjectivesCannabis use is common in people with early-phase psychosis (EP) and is associated with worse treatment outcomes. Few targeted interventions for cannabis use behaviour in this population exist, most focusing on abstinence, none focusing on harm reduction. Many people with EP will not seek treatment for their cannabis use with current therapeutic options. Understanding preferences for cannabis-focused harm reduction interventions may be key to improving outcomes. This study aimed to determine preferences of young adults with EP who use cannabis for cannabis-focused harm reduction interventions.MethodsEighty-nine young adults across Canada with EP interested in reducing cannabis-related harms were recruited. An online questionnaire combining conventional survey methodology and two unique discrete choice experiments (DCEs) was administered. One DCE focused on attributes of core harm reduction interventions (DCE 1) and the second on attributes of boosters (DCE 2). We analysed these using mixed ranked-ordered logistic regression models. Preference questions using conventional survey methodology were analysed using summary statistics.ResultsPreferred characteristics for cannabis-focused harm reduction interventions (DCE 1) were: shorter sessions (60 min vs. 10 min, odds ratio (OR): 0.72; P < 0.001); less frequent sessions (daily vs. monthly, OR: 0.68; P < 0.001); shorter interventions (3 months vs. 1 month, OR: 0.80; P < 0.01); technology-based interventions (vs. in-person, OR: 1.17; P < 0.05). Preferences for post-intervention boosters (DCE 2) included opting into boosters (vs. opting out, OR: 3.53; P < 0.001) and having shorter boosters (3 months vs. 1 month, OR: 0.79; P < 0.01). Nearly half of the participants preferred to reduce cannabis use as a principal intervention goal (vs. using in less harmful ways or avoiding risky situations).ConclusionsFurther research is required to see if technology-based harm reduction interventions for cannabis featuring these preferences translate into greater engagement and improved outcomes in EP patients.
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