在农村初级保健实践中治疗阿片类药物使用障碍的药物:患者和提供者的经验
Nora C Bridges1, Rachel Taber1, Abigail L Foulds2
1Department of Family Medicine, University of Pittsburgh; Schenley Place, Suite 520, 4420 Bayard Street, Pittsburgh, PA 15260, USA.
Journal of substance use and addiction treatment
|August 5, 2023
概括
宾夕法尼亚州农村地区阿片类药物使用障碍 (MOUD) 药物使用障碍在患者和提供者之间存在差异. 解决健康的社会决定因素是改善MOUD获取和减少污名化的关键.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 农村卫生 农村卫生
背景情况:
- 阿片类药物流行不成比例地影响农村社区.
- 在这些地区,对阿片类药物使用障碍 (MOUD) 药物的采用明显较低.
- 宾夕法尼亚州农村获得药物辅助治疗 (RAMP) 项目旨在增加农村初级保健中的MOUD.
研究的目的:
- 了解在宾夕法尼亚州农村地区访问和提供MOUD的多层次障碍和促进者.
- 探索患者和提供者对MOUD访问挑战的不同观点.
主要方法:
- 在RAMP项目中与MOUD患者和提供者进行了35次半结构面试.
- 采用了带有演和归纳方法的定性分析.
- 利用修改后的社会生态框架组织个人,人际关系,医疗保健环境,社区和公共政策层面的发现.
主要成果:
- 患者和医疗服务提供者发现了诸如医疗服务提供者短缺,运输问题和成本等常见障碍.
- 最重要的是,他们对这些障碍的解释和提出的解决方案存在分歧.
- 患者强调了诊所之外的健康的社会决定因素,而提供者则专注于临床角色和操作.
结论:
- 医疗服务提供者应该让患者参与健康障碍的社会决定因素,并寻求社区伙伴关系.
- 结果表明有机会改善农村环境中的患者体验,MOUD访问和护理流程.
- 解决这些因素可以帮助减少与阿片类药物使用障碍 (OUD) 相关的耻辱感.
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