评估2021年布普伦诺芬治疗利用率和SAMHSA数据豁免提供商分布:2021年加利福尼亚州的现实世界分析
Yun Wang1, Tao Hu2, Chih-Hung Chang3
1School of Pharmacy, Chapman University, 9401 Jeronimo Road, Irvine, CA, 92618, USA. yunwang@chapman.edu.
Scientific reports
|August 9, 2025
概括
许多美国县缺乏足够的布普伦诺啡因处方医生来治疗阿片类药物使用障碍 (OUD). 这项研究发现,加利福尼亚州的无数据医生和活跃处方医生之间存在差异,突出了接入问题,特别是在农村地区.
科学领域:
- 成 药物 药物 药物 药物
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 阿片类药物使用障碍 (OUD) 治疗通常涉及布普伦诺芬,这是一种需要医生豁免处方的药物.
- DATA-waiver提供商对处方能力的不充分利用,导致美国许多县的布普伦诺芬获取有限.
- 以前的政策要求豁免,这可能会影响处方者可用性和患者访问.
研究的目的:
- 为了比较活跃的布普伦诺芬处方临床医生的地理可用性与加利福尼亚邮政编码中药物滥用和心理健康服务管理局 (SAMHSA) 列出的DATA免费处方医生.
- 为了确定在加利福尼亚州不同地区布普伦诺芬处方药的分布上的差异.
- 评估豁免与积极处方布普伦诺芬之间的差距.
主要方法:
- 利用了来自加利福尼亚州控制物质利用审查和评估系统 (CURES) 的2021年布普伦诺芬处方数据.
- 从SAMHSA网页获得了所有数据豁免临床医生的列表.
- 我们比较了1600个加利福尼亚邮政编码内的没有数据的医生和活跃的布普伦诺芬处方者.
主要成果:
- 62.1%的患者邮政编码有免费的医生,而57.8%的医生有活跃的布普伦诺芬处方.
- 在没有数据的医生数量和正在处方的医生数量之间观察到显著的不成比例.
- 并非所有拥有DATA豁免的医生都在积极处方布普伦诺芬.
- 在农村和城市地区之间,在获得两种类型的处方者方面发现了显著的差异.
结论:
- 在加利福尼亚州,布普伦诺芬处方药的可用性仍然存在差异,特别影响农村人口.
- 解决这些接入差距需要战略性资源配置和跨专业的合作.
- 最近的政策变化,比如2022年全方位法案,显示出希望,但需要在OUD政策制定中继续努力.
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