cendoc bogani publicaciones PMD conductas adictivas

Fitxa Bibliografía científica

Model-Based Approach to Improve Clinical Outcomes in Neonates With Opioid Withdrawal Syndrome Using Real-World Data

Wijekoon, Nadeesri; Aduroja, Oluwatobi; Biggs, Jessica M.; El-Metwally, Dina; Gopalakrishnan, Mathangi

Any: 2021

At least 60% of the neonates with opioid withdrawal syndrome (NOWS) require morphine to control withdrawal symptoms. Currently, the morphine dosing strategies are empiric, not optimal and associated with longer hospital stay. The aim of the study was to develop a quantitative, model-based, real-world data-driven approach to morphine dosing to improve clinical outcomes, such as reducing time on treatment. Longitudinal morphine dose, clinical response (Modified Finnegan Score (MFS)), and baseline risk factors were collected using a retrospective cohort design from the electronic medical records of neonates with NOWS (N = 177) admitted to the University of Maryland Medical Center. A dynamic linear mixed effects model was developed to describe the relationship between MFS and morphine dose adjusting for baseline risk factors using a split-sample data approach (70% training: 30% test). The training model was evaluated in the test dataset using a simulation based approach. Maternal methadone and benzodiazepine use, and race were significant predictors of the MFS response. Positive autocorrelations of 0.56 and 0.12 were estimated between consecutive MFS responses. On an average, for a 1,000 mu g increase in the morphine dose, the MFS decreased by 0.3 units. The model evaluation showed that observed and predicted median time on treatment were similar (13.0 vs. 13.8 days). A model-based framework was developed to describe the MFS-morphine dose relationship using real-world data that could potentially be used to develop an adaptive, individualized morphine dosing strategy to improve clinical outcomes in infants with NOWS.

Tipo document:

Artículo

Número/Volum:

109

Pàgines:

243 - 252

Font:

CLINICAL PHARMACOLOGY & THERAPEUTICS

 

Comparteix amb altres persones

Compateix Compateix  Compateix

Regidoría de Salut i Consum del Ajuntament de València

Logotipo Universitat de València
Logotipo UISYS
Logotipo CSIC
Logotipo Consellería de Sanitat Universal y Salut Pública de la Generalitat Valenciana

Segueix-nos a:

 

Darrera actualització: 14/04/2021

Centre de documentació sobre drogodependències i altres trastorns addictius Dr. Emilio Bogani Miquel
Cendoc Bogani

Publicacions, Articles, Cartells, Posters i enllaços Web sobre Drogodependències i Trastorns Addictius rellevants per a professionals de les Ciències de la Salut, Educació e Informació.

Copyright © Centro de documentación sobre drogodependencias y otros trastornos adictivos Dr. Emilio Bogani Miquel, 2019.
Cendoc Bogani - C/ Amadeo de Saboya, 11 - bajo - 46010 - Valencia
Utilitzem cookies pròpies i de tercers per a millorar els nostres serveis i amb finalitats estadístics. En continuar amb la navegació entenem que s'accepta la nostra política de cookies. Més Informació