治愈干预社区对过量教育和纳洛分配的影响:一个集群随机化,等候名单控制的试验
Patricia R Freeman1, Alexander Y Walley1, T John Winhusen1
1Patricia R. Freeman and Douglas R. Oyler are with the University of Kentucky College of Pharmacy, Department of Pharmacy Practice and Science, Lexington. Alexander Y. Walley, Trevor J. Baker, and Jeffrey H. Samet are with the Boston Medical Center, Boston, MA. T. John Winhusen is with the University of Cincinnati Department of Psychiatry and Behavioral Neuroscience, Cincinnati, OH. Emmanuel A. Oga, Christian Douglas, JaNae Holloway, Nathan A. Vandergrift, Joella W. Adams, Katherine Asman, LaShawn M. Glasgow, Charles Knott, and Gary A. Zarkin are with RTI International, Research Triangle Park, NC. Jennifer Villani and Redonna K. Chandler are with the National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD. Timothy Hunt, Kitty Gelberg, James L. David, Louisa Gilbert, Dawn A. Goddard-Eckrich, and Nabila El Bassel are with the Columbia University School of Social Work, Social Intervention Group, New York, NY. Brittni Reilly is with the Massachusetts Department of Public Health, Boston. Michael S. Lyons is with Ohio State University Department of Emergency Medicine, Columbus. Candace J. Brancato is with the University of Kentucky College of Public Health, Department of Biostatistics, Lexington. Debbie M. Cheng is with the Boston University School of Public Health, Department of Biostatistics, Boston, MA. Janet E. Childerhose is and Rebecca D. Jackson was with the Ohio State University College of Medicine, Department of Internal Medicine, Columbus. Daniel J. Feaster is with the University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL. Hannah K. Knudsen, Michelle R. Lofwall, Katherine R. Marks, and Sharon L. Walsh are with the University of Kentucky College of Medicine, Department of Behavioral Science, Lexington. Jason T. McMullan is with the University of Cincinnati Department of Emergency Medicine, Cincinnati, OH. Carrie B. Oser is with the University of Kentucky, Department of Sociology, Lexington. Monica Roberts and Josie Watson are with the University of Kentucky Substance Use Priority Research Area, Lexington. Abigail B. Shoben is with the Ohio State University College of Public Health, Division of Biostatistics, Columbus. Michael D. Stein is with the Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, MA. Scott T. Walters is with the University of North Texas Health Science Center, School of Public Health, Fort Worth.
在受阿片类药物危机影响的社区中,社区治愈 (CTH) 干预显著增加了79%的纳洛分布,与受阿片类药物危机影响的社区的通常护理相比,有助于过量预防工作.
科学领域:
- 公共卫生 公共卫生
- 实施科学 实施科学
- 成 药物 药物 药物 药物
背景情况:
- 阿片类药物过量死亡仍然是一个关键的公共卫生问题,需要有效的干预措施.
- 纳洛的分配是减少阿片类药物相关死亡率的关键策略.
- 治疗社区研究 (HCS) 旨在实施基于证据的实践,以应对阿片类药物危机.
研究的目的:
- 评估治愈社区 (CTH) 干预措施的有效性.
- 为了确定CTH是否会增加纳洛的分布,与通常的护理相比.
- 评估CTH对减少阿片类药物过量死亡的影响.
主要方法:
- 一个集群随机化,平行臂,等待列表控制的实施科学试验.
- 67个受阿片类药物过量影响严重的社区被分配给CTH干预或常规护理.
- 主要结局:2021年7月1日至2022年6月30日之间分配的纳洛单位,使用负二项式回归分析.
主要成果:
- 在CTH干预组中,纳洛的分布比常规治疗高79% (调整后的相对比率=1.79,P=.001).
- 调整后的利率显示,在CTH手臂中,每10万居民分配了3378个纳洛单元,而在常规护理手臂中为1884个.
- 结果对城市-农村状态,状态,基线过量死亡率和基线纳洛分布率进行了控制.
结论:
- 在面临阿片类药物危机的社区中,CTH干预有效地增加了纳洛的分布.
- 结果支持CTH干预作为一个成功的策略,以加强过量预防资源.
- 这项研究证明了实施科学在应对公共卫生紧急情况方面的价值.
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