El Hadj Touré, 2023

Références
Archambault L, Bertrand K, Jutras-Aswad D, Monson E, Touré EH, Perreault M. People with opioid use disorders: A taxonomy of treatment entrants to support the development of a profile-based approach to care. Drug Alcohol Rev. 2023 Mar 11. doi: 10.1111/dar.13634.

Abstract
Introduction
People with opioid use disorders (OUD) present with high levels of medical and psychosocial vulnerabilities. In recent years, studies have highlighted a shift in demographic and biopsychosocial profiles of people with OUD. In order to support the development of a profile-based approach to care, this study aims to identify different profiles of people with OUD in a sample of patients admitted to a specialised opioid agonist treatment (OAT) facility.

Methods
Twenty-three categorical variables (demographic, clinical, indicators of health and social precariousness) were retrieved from a sample of 296 patient charts in a large Montréal-based OAT facility (2017–2019). Descriptive analyses were followed by a three-step latent class analysis (LCA) to identify different socio-clinical profiles and examine their association with demographic variables.

Results
The LCA revealed three socio-clinical profiles: (i) “polysubstance use with psychiatric, physical and social vulnerabilities” (37% of the sample); (ii) “heroin use with vulnerabilities to anxiety and depression” (33%); (iii) “pharmaceutical-type opioid use with vulnerabilities to anxiety, depression and chronic pain” (30%). Class 3 individuals were more likely to be aged 45 years and older.

Discussion and Conclusion
While current approaches (such as low- and regular-threshold services) may be suited for many OUD treatment entrants, there may be a need to improve the continuum of care between mental health, chronic pain, and addiction services for those characterised by the use of pharmaceutical-type opioids, chronic pain and older age. Overall, the results support further exploring profile-based approaches to care, tailored to subgroups of patients with differing needs or abilities.

Key Points
Three classes of socio-clinical profiles emerged from the analysis.
Profile 1 is characterised by polysubstance use and multiple vulnerabilities.
Profile 2 is characterised by heroin use and fewer vulnerabilities.
Profile 3 is characterised by older age, chronic pain and pharmaceutical-type opioid use.
Results support further exploring profile-based approaches to care in opioid use disorder.

Lien de l'article
https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.13634