Background

Buprenorphine is first-line opioid agonist therapy for opioid use disorder. Standard regimens require that patients be in opioid withdrawal prior to induction, which is a barrier for many. Micro-induction is a novel induction approach that does not require patients to be in withdrawal. Our primary objective is to synthesize available evidence on the effectiveness of micro-inductions on patient and clinical outcomes compared to standard dosing or other approaches, or evaluated without a comparator group. Secondary objectives are to synthesize evidence on clinical factors that influence micro-induction effectiveness, and to summarize micro-induction regimens described in the literature.

Methods

We will search MEDLINE, Embase, CINAHL, Psycinfo, Science Citation Index, and the grey literature for studies that include adolescents or adults with opioid use disorder who received a buprenorphine micro-induction regimen. We will consider any patient or clinical outcomes defined by study authors. We will include controlled and non-controlled interventional studies, observational studies, case reports/series and reports from relevant organizations or guidelines pertinent to our third objective. We will select studies, extract data and assess study quality (using the Downs and Black, and Cochrane Risk of Bias tools) in duplicate. We will narratively synthesize our results, and will meta-analyze outcome measures if multiple studies report common outcomes with acceptably low heterogeneity.

Discussion

Our review will include the most up-to-date available data on buprenorphine micro-inductions. We anticipate limitations relating to study heterogeneity and quality. We will disseminate study results widely to inform updated guidelines for opioid agonist therapy prescribers.

中文翻译：

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丁丙诺啡引发的微诱导方法的有效性：系统评价方案。

背景

丁丙诺啡是阿片类药物使用障碍的一线类阿片激动剂。标准治疗方案要求患者在诱导前必须停用阿片类药物，这对许多人来说是一个障碍。微诱导是一种新颖的诱导方法，不需要患者退出治疗。我们的主要目标是，与标准剂量或其他方法相比，或在没有比较组的情况下进行评估，以综合获得有关微诱导对患者和临床结果有效性的证据。次要目标是综合影响微诱导效果的临床因素的证据，并总结文献中描述的微诱导方案。

方法

我们将搜索MEDLINE，Embase，CINAHL，Psycinfo，Science Citation Index和灰色文献，以研究包括接受丁丙诺啡微诱导方案的青少年或阿片类药物使用障碍的成年人。我们将考虑研究作者定义的任何患者或临床结局。我们将包括对照和非对照干预研究，观察性研究，病例报告/系列报告以及与我们的第三个目标相关的相关组织或指南的报告。我们将一式两份地选择研究，提取数据并评估研究质量（使用Downs and Black和Cochrane偏倚风险工具）。我们将叙述性地综合我们的结果，并且如果多项研究报告的异质性低至可接受的共同结果，则将对结果测量进行荟萃分析。

讨论区

我们的评论将包括丁丙诺啡微诱导的最新数据。我们预计与研究异质性和质量有关的局限性。我们将广泛传播研究结果，以为阿片类激动剂治疗处方者提供最新指南。