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行动框架:在德克萨斯州开发和实施全州网络,以扩大使用SHIFT证据的阿片类药物治疗机会
Carma Deem Bolton1,2, Erin P Finley3,4, Tara Karns-Wright1,2
1Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Substance use & addiction journal
|June 17, 2025
概括
SHIFT-Evidence框架成功地扩大了德克萨斯州的办公室阿片类药物治疗 (OBOT),通过解决多个医疗保健层面的系统障碍,增加了患者获得阿片类药物使用障碍 (MOUD) 药物的机会.
科学领域:
- 公共卫生 公共卫生
- 卫生系统研究 卫生系统研究
- 实施科学 实施科学
背景情况:
- 在德克萨斯州,阿片类药物使用障碍 (OUD) 治疗的准入是一个主要的挑战.
- 服务不足的人群面临着有效的OUD护理的重大障碍.
- 通过将证据转化为复杂系统 (SHIFT-Evidence) 框架,成功改善医疗保健提供了一种结构化的方法来解决这些问题.
研究的目的:
- 展示SHIFT-Evidence框架的应用,用于开发和实施全州范围的办公室阿片类药物治疗 (OBOT) 网络.
- 为了改善德克萨斯州服务不足的人口对阿片类药物使用障碍 (MOUD) 药物的获取.
主要方法:
- 进行了需求评估,以确定布普伦诺芬处方的障碍和促进者.
- 利用SHIFT-Evidence框架指导战略选择,以解决多个医疗保健系统层面的实施障碍.
- 分析了德克萨斯州州立卫生服务部行为健康服务临床管理数据系统的数据,以评估计划覆盖范围和客户服务.
主要成果:
- SHIFT-Evidence框架促进了多层次障碍的识别 (患者,处方者,组织) 和量身定制的策略的选择.
- 成功开发和扩展了OBOT提供商网络,从2019财年为52个客户服务的6个组织 (10个地点) 增加到2023财年为1311个客户服务的23个组织 (48个地点).
- 在该计划中展示了增加的地理范围和客户服务.
结论:
- SHIFT-Evidence框架的全面,多层次的方法有效地解决了OUD治疗中的系统性差距.
- 该框架对于规划和确定优先级非常有用,从而在复杂的医疗保健系统中提高了治疗机会.
- 成功实施突显了该框架对改善OUD医疗保健服务的实用性.
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