The future of precision medicine in opioid use disorder: Inclusion of patient-important outcomes in clinical trials

Nitika Sanger, Balpreet Panesar, Tea Rosic, Brittany Dennis, Alessia D’Elia, Alannah Hillmer, Caroul Chawar, Leen Naji, Jacqueline Hudson, M. Constantine Samaan, Russell J. De Souza, David C. Marsh, Lehana Thabane, Zainab Samaan

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objective: Opioid use has reached an epidemic proportion in Canada and the United States that is mostly attributed to excess availability of prescribed opioids for pain. This excess in opioid use led to an increase in the prevalence of opioid use disorder (OUD) requiring treatment. The most common treatment recommendations include medication-assisted treatment (MAT) combined with psychoso-cial interventions. Clinical trials investigating the effectiveness of MAT, however, have a limited focus on effectiveness measures that overlook patient-important outcomes. Despite MAT, patients with OUD continue to suffer negative consequences of opioid use. Patient goals and personalized medicine are overlooked in clinical trials and guidelines, thus missing an opportunity to improve prognosis of OUD by considering precision medicine in addiction trials. Methods: In this mixed-methods study, patients with OUD receiving MAT (n=2,031, mean age 39.1 years [SD 10.7], 44% female) were interviewed to identify patient goals for MAT. Results: The most frequently reported patient-important outcomes were to stop treatment (39%) and to avoid all drugs (25%). Conclusion: These results are inconsistent with treatment recommendations and trial outcome measures. We discuss theses inconsistencies and make recommendations to incorporate these outcomes to achieve patient-centered and personalized treatment strategies.

Original languageEnglish (US)
Pages (from-to)138-146
Number of pages9
JournalRevista Brasileira de Psiquiatria
Volume43
Issue number2
DOIs
StatePublished - Mar 1 2021
Externally publishedYes

Keywords

  • Clinical trials
  • Opioid
  • Outcomes
  • Patient important

ASJC Scopus subject areas

  • Psychiatry and Mental health

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