药物治疗阿片类药物使用障碍在马萨诸塞州严重注射相关感染后
Simeon D Kimmel1,2, Alexander Y Walley1, Laura F White3
1Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, Massachusetts.
JAMA network open
|July 24, 2024
概括
严重的注射相关感染 (SIRI) 很常见,再住院和死亡率很高. 治疗阿片类药物使用障碍 (MOUD) 的药物改善了结果,但在SIRI之后使用不足,突出了关键的护理差距.
科学领域:
- 传染性疾病 传染性疾病
- 成 药物 药物 药物 药物
- 公共卫生 公共卫生
背景情况:
- 严重的注射相关感染 (SIRI) 对发病率和死亡率做出了重大贡献.
- 对阿片类药物使用障碍 (MOUD) 的药物治疗是有效的,但在这个人群中未得到充分利用.
- 了解SIRI后的MOUD治疗模式对于改善患者的治疗结果至关重要.
研究的目的:
- 调查因SIRI住院的个人中的再住院,死亡率和MOUD接收情况.
- 为了确定与在SIRI住院后接受MOUD相关的患者特征.
主要方法:
- 使用马萨诸塞州公共卫生数据仓库 (2014-2019) 进行的回顾性队列研究.
- 包括18至64岁的阿片类药物使用障碍患者,因特定SIRI (内心炎,骨髓炎等) 住院治疗. ) 的情况.
- 使用回归模型分析了MOUD接收,再住院和住院后12个月内死亡率.
主要成果:
- 在8769名患者中,近一半 (49.1%) 接受了MOUD后SIRI住院治疗.
- 在12个月内观察到高的再住院率 (67.5%) 和死亡率 (11.1%) .
- 之前使用MOUD (布普诺芬,美沙) 强烈预测住院后的MOUD启动和治疗持续时间.
结论:
- 在SIRI住院后,死亡率和再住院是常见的,只有一半的患者接受MOUD.
- 在SIRI前的MOUD治疗与住院后的MOUD启动和持续治疗的增加有关.
- 在SIRI住院期间和之后,需要进行干预,以启动和维持MOUD.
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