与支持办公室美沙酮有关的临床医生和实践特征:一项全国调查的结果。

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE Journal of Addiction Medicine Pub Date : 2024-10-30 DOI:10.1097/ADM.0000000000001388
Minhee L Sung, Anne C Black, Derek Blevins, Brandy F Henry, Kathryn Cates-Wessel, Michael A Dawes, Holly Hagle, Paul J Joudrey, Todd Molfenter, Frances R Levin, David A Fiellin, E Jennifer Edelman
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引用次数: 0

摘要

背景:在联邦和州监管的阿片类药物治疗项目之外提供美沙酮的替代模式可能会提高美沙酮的可及性。我们确定了临床医生支持继续在诊室提供美沙酮的相关因素:我们使用了来自阿片类药物使用障碍提供者 COVID-19 电子调查的数据,调查对象是 2020 年 7 月至 2020 年 8 月期间提供阿片类药物使用障碍(OUD)门诊纵向治疗的 X-waivered 临床医生。当被问及 "您希望在大流行后继续或开始哪些与大流行相关的政策变化或新的政策变化?"时,结果变量为选择 "患者有机会在门诊接受美沙酮治疗"。我们使用顺序多变量逻辑回归模型估算了临床医生和诊所特征与支持诊所美沙酮之间的关系:在 1900 名受访者中,有 728 人符合纳入标准。28%的受访者表示支持办公室美沙酮。与支持诊室美沙酮有关的临床医生特征包括:黑人或非裔美国人与白人(调整后的几率比[AOR][95% 置信区间 (CI)],2.88 [1.19-6.98]),提供 OUD(MOUD)药物治疗时间大于 15 年与小于 15 年(AOR [95% CI],1.66 [1.02-2.68]),每月治疗 51 至 100 名 MOUD 患者与结论:少数接受调查的 X-Waivered 临床医生支持在诊室使用美沙酮。通过诊室环境扩大美沙酮使用范围的努力应解决实施障碍。
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Clinician and Practice Characteristics Associated With Support of Office-Based Methadone: Findings From a National Survey.

Background: Alternative models for methadone delivery outside of federal and state-regulated opioid treatment programs may improve access. We determined factors associated with clinician support for continuing office-based methadone.

Methods: We used data from the electronic Opioid Use Disorder Provider COVID-19 Survey conducted among X-waivered clinicians who were providing outpatient, longitudinal treatment of opioid use disorder (OUD) from July 2020 to August 2020. The outcome variable was selecting "The opportunity for patients to receive office-based methadone" when asked "Which pandemic-related policy changes or new policy changes would you like to be continued or started after the pandemic?" Using sequential multivariable logistic regression modeling, we estimated the association between clinician and practice characteristics and support for office-based methadone.

Results: Of 1900 respondents, 728 met the inclusion criteria. Twenty-eight percent indicated support for office-based methadone. Clinician characteristics associated with support for office-based methadone were being Black or African American versus White (adjusted odds ratio [AOR] [95% confidence interval (CI)], 2.88 [1.19-6.98]), having provided medications for OUD (MOUD) for >15 years versus ≤15 years (AOR [95% CI], 1.66 [1.02-2.68]), treating 51 to 100 patients with MOUD monthly versus <25 patients (AOR [95% CI], 1.79 [1.04-3.09]), providing methadone (AOR [95% CI], 1.71 [1.03-2.85]) versus not providing MOUD previously, and working in an academic medical center versus other settings (AOR [95% CI], 1.88 [1.11-3.16]).

Conclusions: A minority of surveyed X-waivered clinicians supported office-based methadone. Efforts to expand access to methadone via office-based settings should address implementation barriers.

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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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