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dc.contributor.authorAlcaraz, Saul
dc.contributor.authorGonzález-Saiz, Francisco
dc.contributor.authorTrujols, Joan
dc.contributor.authorVergara-Moragues, Esperanza (1)
dc.contributor.authorSinol, Nuria
dc.contributor.authorPérez de los Cobos, José
dc.description.abstractBackground: Buprenorphine dosage is a crucial factor influencing outcomes of buprenorphine treatment for heroin use disorders. Therefore, the aim of the present study is to identify naturally occurring profiles of heroin-dependent patients regarding individualized management of buprenorphine dosage in clinical practice of buprenorphine-naloxone maintenance treatment. Methods: 316 patients receiving buprenorphine-naloxone maintenance treatment were surveyed at 16 Spanish centers during the stabilization phase of this treatment. Patients were grouped using cluster analysis based on three key indicators of buprenorphine dosage management: dose, adequacy according to physician, and adjustment according to patient. The clusters obtained were compared regarding different facets of patient clinical condition. Results: Four clusters were identified and labeled as follows (buprenorphine average dose and percentage of participants in each cluster are given in brackets): "Clinically Adequate and Adjusted to Patient Desired Low Dosage" (2.60 mg/d, 37.05%); "Clinically Adequate and Adjusted to Patient Desired High Dosage" (10.71 mg/d, 29.18%); "Clinically Adequate and Patient Desired Reduction of Low Dosage" (3.38 mg/d, 20.0%); and "Clinically Inadequate and Adjusted to Patient Desired Moderate Dosage" (7.55 mg/d, 13.77%). Compared to patients from the other three clusters, participants in the latter cluster reported more frequent use of heroin and cocaine during last week, lower satisfaction with buprenorphine-naloxone as a medication, higher prevalence of buprenorphine-naloxone adverse effects and poorer psychological adjustment. Conclusions: Our results show notable differences between clusters of heroin-dependent patients regarding buprenorphine dosage management. We also identified a group of patients receiving clinically inadequate buprenorphine dosage, which was related to poorer clinical condition.es_ES
dc.publisherDrug and Alcohol Dependencees_ES
dc.relation.ispartofseries;vol. 187
dc.subjectbuprenorphine-naloxone treatmentes_ES
dc.subjectheroin dependencees_ES
dc.subjectdosage managementes_ES
dc.subjectcluster analysises_ES
dc.subjecttreatment outcomeses_ES
dc.titleA cluster-analytic profiling of heroin-dependent patients based on level, clinical adequacy, and patient-desired adjustment of buprenorphine dosage during buprenorphine-naloxone maintenance treatment in sixteen Spanish centerses_ES
dc.typeArticulo Revista Indexadaes_ES

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