阿片类药物使用障碍研究:为期 18 个月的阿片类药物使用障碍患者治疗研究的方法和初步结果。

IF 3 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Public Health Reports Pub Date : 2024-07-01 Epub Date: 2024-01-25 DOI:10.1177/00333549231222479
Jill A Dever, Marci F Hertz, Laura J Dunlap, John S Richardson, Sara Beth Wolicki, Bradley B Biggers, Mark J Edlund, Michele K Bohm, Didier Turcios, Xinyi Jiang, Hong Zhou, Mary E Evans, Gery P Guy
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引用次数: 0

摘要

目标:美国每年约有 560 万人受到阿片类药物使用障碍(OUD)的影响,但使用有效药物治疗 OUD(MOUD)的比例却很低。我们从 2017 年 8 月到 2021 年 5 月开展了一项观察性队列研究,即 MOUD 研究,以更好地了解治疗参与度以及可能影响治疗体验和结果的因素。本文将介绍研究设计、收集的数据和治疗结果:我们招募了在美国门诊机构接受 OUD 治疗的成年患者参与 MOUD 研究。我们通过自填问卷和健康记录数据收集了5个时间点(基线至18个月)的患者层面数据。我们在 2 个时间点通过向机构负责人发放调查问卷的方式收集机构层面的数据。共有 16 个州的 62 家 OUD 治疗机构参与了研究,1974 名患者加入了研究。我们总结了患者和 OUD 治疗机构的特征描述数据以及选定的治疗结果:62 家机构中约有一半是私营非营利组织;62% 主要侧重于药物使用治疗;20% 还提供心理健康服务。大多数参与者正在接受美沙酮(61%)或丁丙诺啡(32%)治疗,主要为非西班牙裔白人(68%)、25-44 岁(62%)和女性(54%)。与患者报告的基线估计值相比,18 个月的估计值表明,戒断率有所上升(从 55% 上升到 77%),与阿片类药物相关的过量使用率(从 7% 下降到 2%)、急诊就诊率(从 9% 下降到 4%)和逮捕率(从 15% 下降到 7%)有所下降:我们的研究结果表明,通过长期收集数据,坚持治疗不仅对戒断阿片类药物使用有好处,而且对其他生活质量指标也有好处。MOUD 研究提供了丰富的多层次数据,可为建立证据基础奠定基础,为 OUD 治疗提供依据,并支持改善护理和患者预后。
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The Medications for Opioid Use Disorder Study: Methods and Initial Outcomes From an 18-Month Study of Patients in Treatment for Opioid Use Disorder.

Objective: Opioid use disorder (OUD) affects approximately 5.6 million people in the United States annually, yet rates of the use of effective medication for OUD (MOUD) treatment are low. We conducted an observational cohort study from August 2017 through May 2021, the MOUD Study, to better understand treatment engagement and factors that may influence treatment experiences and outcomes. In this article, we describe the study design, data collected, and treatment outcomes.

Methods: We recruited adult patients receiving OUD treatment at US outpatient facilities for the MOUD Study. We collected patient-level data at 5 time points (baseline to 18 months) via self-administered questionnaires and health record data. We collected facility-level data via questionnaires administered to facility directors at 2 time points. Across 16 states, 62 OUD treatment facilities participated, and 1974 patients enrolled in the study. We summarized descriptive data on the characteristics of patients and OUD treatment facilities and selected treatment outcomes.

Results: Approximately half of the 62 facilities were private, nonprofit organizations; 62% focused primarily on substance use treatment; and 20% also offered mental health services. Most participants were receiving methadone (61%) or buprenorphine (32%) and were predominately non-Hispanic White (68%), aged 25-44 years (62%), and female (54%). Compared with patient-reported estimates at baseline, 18-month estimates suggested that rates of abstinence increased (55% to 77%), and rates of opioid-related overdoses (7% to 2%), emergency department visits (9% to 4%), and arrests (15% to 7%) decreased.

Conclusions: Our results demonstrated the benefits of treatment retention not only on abstinence from opioid use but also on other quality-of-life metrics, with data collected during an extended period. The MOUD Study produced rich, multilevel data that can lay the foundation for an evidence base to inform OUD treatment and support improvement of care and patient outcomes.

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来源期刊
Public Health Reports
Public Health Reports 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.00
自引率
6.10%
发文量
164
审稿时长
6-12 weeks
期刊介绍: Public Health Reports is the official journal of the Office of the U.S. Surgeon General and the U.S. Public Health Service and has been published since 1878. It is published bimonthly, plus supplement issues, through an official agreement with the Association of Schools and Programs of Public Health. The journal is peer-reviewed and publishes original research and commentaries in the areas of public health practice and methodology, original research, public health law, and public health schools and teaching. Issues contain regular commentaries by the U.S. Surgeon General and executives of the U.S. Department of Health and Human Services and the Office of the Assistant Secretary of Health. The journal focuses upon such topics as tobacco control, teenage violence, occupational disease and injury, immunization, drug policy, lead screening, health disparities, and many other key and emerging public health issues. In addition to the six regular issues, PHR produces supplemental issues approximately 2-5 times per year which focus on specific topics that are of particular interest to our readership. The journal''s contributors are on the front line of public health and they present their work in a readable and accessible format.
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